Paraesophageal hiatal hernia (chest x-ray)

Case contributed by Marcin Czarniecki
Diagnosis almost certain


Routine chest x-ray performed prior to a planned cholecystectomy

Patient Data

Age: 70 years
Gender: Female

PA chest X-ray


The mediastinum is enlarged with a retrocardiac lucency indicative of a gas-filled structure. The findings are in keeping with a hiatus (paraesophageal) hernia.

Case Discussion

Many patients that are diagnosed in the imaging department are asymptomatic. Hiatus hernias occur in two subtypes - rolling and sliding, with the latter being much more common.

The finding must be differentiated from a retrocardiac abscess, empyema or epiphrenic diverticulum.

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