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Upright, double contrast films of the gastro-esophageal junction were reviewed in 30 patients with hiatal hernias and 30 normal controls. Patients with hiatal hernias demonstrated gastro-esophageal folds that converged above the diaphragm and diverged at or beneath the diaphragm on double contrast films of the esophagus. In the normal situation these folds were found to converge at or beneath the diaphragm. The origin and significance of this sign for the diagnosis of hiatal hernias in the upright position is discussed.
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