Case Of the Week (COW) 01 Dec 2013
Answer:
Hiatus Hernia.
Findings:
Retrocardiac opacity with air pocket, Abdominothoracic sign - posterior mediastinal lesion in continuity with abdominal organ.
Discussion:
Types of hiatus hernia: Sliding, Rolling and Mixed.
Sliding hernia: OG junction displaced > 1cm above the hiatus. Oesophageal hiatus widened > 15mm. Gastric fundus may be intrathoracic which appears as retrocardiac opacity with air - fluid level.
Rolling hernia: OG junction remains at normal position, but portion of stomach herniates above the diaphragm in paraesophageal location.
Mixed hernia: OG junction displaced into thorax along with a large portion of stomach which is usually abnormally rotated.
Contributed By:
Dr. Iyappan Ponnuswamy, Dr. Lakshmi Varadarajulu, Dr. Sushila Krishnan, Dr. Ramesh Mohandoss
Kauvery Hospital, Alwarpet, Chennai
Answer:
Hiatus Hernia.
Findings:
Retrocardiac opacity with air pocket, Abdominothoracic sign - posterior mediastinal lesion in continuity with abdominal organ.
Discussion:
Types of hiatus hernia: Sliding, Rolling and Mixed.
Sliding hernia: OG junction displaced > 1cm above the hiatus. Oesophageal hiatus widened > 15mm. Gastric fundus may be intrathoracic which appears as retrocardiac opacity with air - fluid level.
Rolling hernia: OG junction remains at normal position, but portion of stomach herniates above the diaphragm in paraesophageal location.
Mixed hernia: OG junction displaced into thorax along with a large portion of stomach which is usually abnormally rotated.
Contributed By:
Dr. Iyappan Ponnuswamy, Dr. Lakshmi Varadarajulu, Dr. Sushila Krishnan, Dr. Ramesh Mohandoss
Kauvery Hospital, Alwarpet, Chennai