Multidimensional Care II (MDC II) Exam 2 Practice

Paraesophageal hernia is defined by the gastroesophageal junction staying below the diaphragm while a portion of the stomach, typically the fundus and part of the greater curvature, herniates through the esophageal hiatus into the thorax beside the esophagus. This distinguishes it from a sliding hiatal hernia, where the gastroesophageal junction itself moves above the diaphragm into the chest. The key clinical note is that the herniated portion can become susceptible to twisting or strangulation because its connection is more rigid at the hiatus, even though the junction remains in place. On imaging, you’d see the stomach fundus in the thoracic cavity with the gastroesophageal junction still below the diaphragm. The other scenarios either involve the junction migrating into the chest or involve other organs, which do not match the characteristic pattern of a paraesophageal hernia.