True about hiatus hernia

HIATUS HERNIA is the most common type of a diaphragmatic hernia classified into type 1 -commonest, small, reducible and is the cephalad displacement of the gastro oesophagal junction into the mediastinum. type 2 -superior migration of fundus of the stomach alongside the GE junction type 3 -combination of both sliding hernia is most commonly associated with GORD. A rolling hernia (para-oesophageal )common in elderly.The usual clinical features include postprandial bloating, dysphagia and early satiety.This can lead to complications such as gangrene of stomach, perforations, volvulus ischaemic longitudinal gastric ulcer. treatment is always surgical. *excision of the sac and repair of the defect.mesh reinforcement to close the hiatus may be required.approaches can be abdominal, thoracic or laparoscopic. Ref: SRB&;s manual of surgery,5th ed, pg no 796