The picture shows such a hernia as seen by inversion of the endoscope. The first narrowness in the foreground corres- ponds to the esophageal penetration through the diaphragm. Visible in the background are those parts of the stomach, which are displaced to the thoracic cavity. The role axial hernias play in the development of reflux esophagitis is not fully understood, since most axial hernias show no esophagitis. In contrast most cases of esophagitis occurr in the presence of axial sliding hiatal hernias.
Symptoms are regurgitation, retrosternal burns and a feeling of distension.
Initially the precardial stenosis can not be passed with the endoscope. The patient was treated by multiple bougienages and was put on proton pump inhibitors.