Intrathoracic stomach

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Follow up after left breast lumpectomy

Patient Data

Age: 55
Gender: Female

CT Chest with contrast

Modality: CT

The stomach is herniated at the lower mediastinum with preserved gastroduodenal junction in place. It showed diffuse wall thickening (endoscopy not available). It displaces the descending thoracic aorta to the left side and compresses the surrounding lung parenchyma. 

Other findings:

  • right sided aortic arch with aberrant left subclavian artery
  • cardiac enlargement
  • nodular goiter
  • fluid collection at the surgical bed of left lumpectomy
  • scoliosis of the lumbar spine with convexity to the right
  • right renal upper pole cyst

Case Discussion

Intrathoracic stomachs are rare and considered the end stage of a hiatus hernia. Type IV hiatus hernias are the total herniation of the stomach. Other organs can also be herniated into the chest such as the colon, omentum, small bowel, and liver.

In addition, there is a right-sided aortic arch with aberrant left subclavian artery (type II), which is displaced to the left side by the herniated stomach.

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Case Information

rID: 43563
Case created: 16th Mar 2016
Last edited: 28th Dec 2016
Inclusion in quiz mode: Excluded

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