Presentation
Reflux and respiratory distress.
Patient Data
Age: 50 years
Gender: Female
From the case:
Paraesophageal hiatal hernia
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In the scout projection a retrocardiac mass is seen.
![](https://prod-images-static.radiopaedia.org/images/5614087/1cdc63c6c551dc12d362862fd39372_thumb.jpg)
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![This study is a stack](/packs/stack-YQKLCKBI.gif)
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![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/5615915/1765f887ace27150fcff49ce13ddbf_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/5616271/389ae654f97caa0d74ff36b76191c0_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/5616613/2bf6353928ea837b36743344353fff_thumb.jpg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
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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.