Now let’s answer some questions about our patient’s hiatal hernia
1. Is it a type I or a type II-IV?
Type II-IV (specifically II and IV), since we see that the GEJ remains intra-abdominal while both the stomach and another portion of bowel have herniated
2. Is there rotation or other signs of gastric volvulus?
Yes. There is inversion of the greater and lesser curvature along the axis of the stomach, making this an organoaxial rotation. However, there is also free passage of barium and the stomach is not overly distended, indicating that no obstruction currently exists.