American Board of Surgery Qualifying Exam (ABS QE) Practice Test 2025 - Free Surgery Exam Practice Questions and Study Guide

Question: 1 / 650

In a Type 1 Paraesophageal Hernia (PEH), where is the gastroesophageal junction positioned?

Below the diaphragm

Above the diaphragm

In a Type 1 Paraesophageal Hernia, also known as a sliding hiatal hernia, the gastroesophageal junction is positioned above the diaphragm. This occurs due to a displacement of a portion of the stomach, specifically the gastroesophageal junction, through the esophageal hiatus and into the thoracic cavity. This type of hernia is characterized by the stomach sliding into the thorax when the patient is supine or when intra-abdominal pressure increases.

Understanding the anatomy is crucial in this context, as the diaphragm serves as a muscular boundary that separates the thoracic cavity from the abdominal cavity. When the gastroesophageal junction moves above the diaphragm, it indicates a relaxation of the normal anatomy, contributing to reflux symptoms experienced by patients with this type of hernia. The other options reference positions that do not accurately capture the anatomy associated with a Type 1 Paraesophageal Hernia.

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At the level of the diaphragm

Intra-abdominal

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