Presentation
Screening
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
On scout, a round opacity is seen behind the heart with an absent gastric air bubble at the upper abdomen.
On axial CT cuts, the stomach is seen herniating through a widened esophageal hiatus into the posterior mediastinum.
Case Discussion
Hiatal hernia occurs when part of the stomach protrudes into the thoracic cavity. It appears on plain chest radiographs as a retrocardiac gas-filled structure. An upper GI barium series is the preferred examination. CT scans are useful in the accurate anatomic depiction of a totally intrathoracic stomach, especially in patients with suspected gastric volvulus.