In 1933, Äkerlung1 offered a simple classification of esophageal hiatus hernias. The three basic types are (1) short esophagus with thoracic stomach; (2) normal esophagus with paraesophageal hernia; (3) normal esophagus with pulsion type hernia.
Harrington's2 excellent reports on the embryology, anatomy, and therapy of the various hiatal hernias have stimulated interest in their clinical recognition. The erroneous concept that hiatus hernia is a benign, structural curiosity incapable of serious portent is rapidly declining.
The least common of the hiatal hernias is that type associated with true short esophagus. Certainly it is less commonly recognized by the clinician and the roentgenologist than are the more obvious paraesophageal hernias. Endoscopists have called attention to short esophagus for years and, for the most part, have inherited the management of the disease. With the general lack of interest and failure in recognition, there has been associated unawareness of the serious possibilities