A hiatal hernia is a condition where the stomach moves upward into the thoracic cavity. The esophagus joins the stomach just past the opening in the diaphragm. In some instances the stomach can move up through that same opening and become a hiatal hernia. “Pat” is a thirty-five year old female that has come to a hospital because she has had reflux problems recently. Like many hiatal hernias Pats' was discovered after a regular visit to the doctor. From that point, any of the following would be