Presentation
Routine chest x-ray performed prior to a planned cholecystectomy
Patient Data
Age: 70 years
Gender: Female
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The mediastinum is enlarged with a retrocardiac lucency indicative of a gas-filled structure. The findings are in keeping with a hiatus (paraesophageal) hernia.
Case Discussion
Many patients that are diagnosed in the imaging department are asymptomatic. Hiatus hernias occur in two subtypes - rolling and sliding, with the latter being much more common.
The finding must be differentiated from a retrocardiac abscess, empyema or epiphrenic diverticulum.
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