Presentation
Epigastric pain.
Patient Data
Age: 40 years
Gender: Male
From the case:
Mixed hiatal hernia with organoaxial gastric volvulus
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Intrathoracic herniation of the stomach through a large esophageal hiatus with organo-axial volvulus of the stomach. Both, the gastric fundus and gastro-esophageal junction are above the diaphragm.
Otherwise unremarkable abdominopelvic CT.
Case Discussion
CT features of a mixed or compound hiatus hernia with organo-axial volvulus of stomach.
The mixed or compound (rolling and sliding) hiatus hernia is the most common type of paraesophageal hernia. The GEJ is displaced into the thorax with a large portion of the stomach, which is usually abnormally rotated. Large paraesophageal hernias, with most of the stomach in the thorax, increase the risk for complications such as volvulus, obstruction, and ischemia.
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