Paraesophageal hiatal hernia

Case contributed by David Cuete
Diagnosis almost certain

Presentation

Reflux and respiratory distress.

Patient Data

Age: 50 years
Gender: Female
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Info

In the scout projection a retrocardiac mass is seen.

CT abdomen and pelvis

ct
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
Sagittal C+ portal
venous phase
This study is a stack
Axial lung
window
This study is a stack
lung
window
This study is a stack
Sagittal
bone window
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Info

The stomach is mostly intrathoracic. The gastro-esophageal junction and adjacent gastric fundus are located in a subdiaphragmatic position. The remainder of the stomach and the duodenal bulb are intrathoracic. The second part of the duodenum returns through the esophageal hiatus to the abdomen.

There are no signs of obstruction or volvulus.

Case Discussion

This is a mixed paraesophageal and sliding or rolling hiatus hernia based on the position of the gastro-esophageal junction and duodenal bulb.

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