Hiatus hernias of the stomach and their complications, such as peptic ulcer and gastritis, are a grateful field for roentgen diagnosis. Clinical symptoms of great variety, often as alarming as sudden hematemesis, can be explained by roentgen demonstration of the displaced segment of the stomach. The importance of including hiatus hernia of the stomach in the differential diagnosis of bleeding lesions of the upper gastro-intestinal tract will justify the presentation of three additional cases of this kind recently observed on the medical service of Sparks Memorial Hospital. The general classification of the diaphragmatic hernias and the mechanism leading to the displacement of portions of the stomach through the esophageal hiatus into the thorax, the so-called hiatus hernia, have been presented in excellent papers (4, 8). The hiatus hernia may or may not be combined with a congenitally short esophagus, the presence of which plays an important, but not an exclusive, part in the origin of this condition. Insufficiency of the muscular hiatus and of the surrounding connective tissue, acquired with advancing age, is considered the decisive etiologic factor. The positive pressure within the abdomen gradually forces segments of the stomach through the weakened hiatus into the thorax, where negative pressure exists. Sixteen cases of hiatus hernia of the stomach have been observed in 1,000 consecutive gastro-intestinal examinations in the x-ray departments of Sparks Memorial Hospital and the Holt-Krock Clinic. This number includes only cases in which a sizable barium deposit outlining a gastric mucosal pattern was demonstrable above the diaphragm. A reflux of barium into the lower esophagus due to relaxation of the cardiac sphincter was more frequently found, but such cases are not included in this series. The majority of the patients with true hiatus hernia were beyond fifty years of age. There were 8 females and 8 males. In a surprisingly large proportion of the cases, 5 out of 16, the diaphragmatic hernia was complicated by other lesions in the gastro-intestinal tract, an observation which has likewise been made by other authors (6). Duodenal ulcers were found in 2 cases, primary adenocarcinoma of the ileum with intestinal obstruction in another, while the 2 remaining patients showed multiple diverticula in the colon. The combination of diaphragmatic hernia with diverticulosis of the colon is well explained by the fact that both conditions are due to senile insufficiency of muscular and connective tissue. In 3 of the 11 cases in which no other gastro-intestinal lesion was present, the hiatus hernia was practically asymptomatic. In 5, different degrees of epigastric pain and other digestive symptoms were recorded, and sufficiently well explained by the presence of the herniated stomach. A small peptic ulcer was found in only 1 of these patients. There was satisfactory response to medical management in all cases in this group.