Esophageal mucosa in the foreground, gastric mucosa in the background. A hiatal hernia occurs when a portion of the stomach prolapses through the diaphragmatic esophageal hiatus. Although the existence of hiatal hernia has been described in earlier medical literature, it has come under close scrutiny only in the last century or so because of its association with gastroesophagealreflux disease (GERD) and its complications. By far, the majority of hiatal hernias are asymptomatic and are discovered incidentally. On rare occasion, a life-threatening complication, such as gastric volvulus or strangulation, may present acutely.
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