Presentation
Follow up after left breast lumpectomy.
Patient Data
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 and a Kommerell's diverticulum
- cardiac enlargement
- nodular goiter
- a 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
The intrathoracic stomach is 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, kidney 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, and a Kommerell's diverticulum.
Unable to process the form. Check for errors and try again.