Figure 13 - Type III paraesophageal hiatal hernia.

In this example, much of the stomach has herniated into the chest, but the leading edge of the herniating stomach has additionally herniated through a weakening of the phrenoesophageal membrane, contributing a paraesophageal component to the hernia. Because the EGJ is well above the diaphragmatic hiatus, this is a mixed, or type III, paraesophageal hernia. (Source: Kahrilas and Pandolfino,⁷⁵ with permission.)