Chest x-ray shows a retrocardiac air-fluid filled structure.

Upper GI Barium study is a preferred method of investigating a hiatus hernia.

CT is used when more anatomical localization is required.

Patients are usually asymptomatic. However, hiatus hernia can mimic many disorders and have variety of symptoms like dull chest pains, shortness of breath and palpitations. GERD also happens more frequently in the presence of hiatus hernia.