Large hiatus hernia

Case contributed by Dr James Sheldon

Presentation

Chest pain

Patient Data

Age: 87 years
Gender: Female
X-ray

Lucency in a retrocardiac location. This may represent a hiatus hernia.

CT

 

Large hiatus hernia containing the entire stomach (not distended and does not appear volved), body and tail of pancreas, large bowel (splenic flexure), omentum and vessels (including splenic artery and vein). Normal enhancement of the stomach wall.

Intrahepatic biliary dilatation. The CBD measures up to 13mm, which even in this age group and post-cholecystectomy is more prominent than expected. Dilated pancreatic duct within the pancreatic head (6mm). Air and fluid filled duodenal diverticulum.

Calcified liver granulomas. Subcentimeter hypodense right kidney lesions too small to definitively characterize on CT but likely cysts.

2.7cm x 2.2cm x 3.0cm left adnexal mass, possibly ovarian in origin although the left ovary is not identified.

Case Discussion

HH containing stomach may result in gastric volvulus, which in turn presents as intestinal obstruction and may result in ischemia/infarction. 

The stomach does not appear volved on this study.

PlayAdd to Share

Case information

rID: 36920
Published: 17th May 2015
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.