Large hiatal hernia

Case contributed by Ryan Thibodeau


Found after fall from standing.

Patient Data

Age: 90 years
Gender: Male

Thorax: there is a large hiatal hernia which involves most if not all of the stomach, duodenum, and mesenteric fat. There is also herniation of the pancreatic head and uncinate process above the diaphragm and into the thorax. There is adjacent compressive atelectasis and dependent atelectasis of medial right lower lobe. There is also mild compressive atelectasis on the left.

Genitourinary: severely atrophic left kidney and mildly atrophic right kidney. There are several dependent bladder calcifications, with the largest measuring 0.4 cm in size.

Bones: there are multilevel degenerative changes comprising endplate osteophyte formation as well as uncovertebral and facet arthropathy. There is an age indeterminate mild anterior compression deformity at T7.

Case Discussion

This is a case of an incidentally noted herniation of abdominal contents (part of the pancreas, stomach, and duodenum). The patient was discharged back to his skilled nursing facility.

Camille Dumas, DO
Christine Cooley, MD

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