The radiological appearance of hiatal hernia repairs

The 4 major types of hiatal hernia repairs are described with regard to the surgical procedures, postoperative radiological manifestations, and differential features. Following a diaphragmatic crural repair, no subdiaphragmatic esophagus is seen. The fundus of the stomach appears normal. Other common procedures create an intraabdominal esophagus; fundoplication creates a 'fundic pseudotumor' effect, posterior gastropexy leaves a smoothly curved lower esophagus, and Mark IV repair creates an acutely angulated terminal esophagus. Recognition of these features is essential in analyzing the effectiveness of the repair and in evaluating surgical complications.