Presentation
Chest pain
Patient Data
Lucency in a retrocardiac location. This may represent a hiatus hernia.
Large hiatus hernia containing the entire stomach (not distended and does not appear volved), body and tail of pancreas, large bowel (splenic flexure), omentum and vessels (including splenic artery and vein). Normal enhancement of the stomach wall.
Intrahepatic biliary dilatation. The CBD measures up to 13mm, which even in this age group and post-cholecystectomy is more prominent than expected. Dilated pancreatic duct within the pancreatic head (6mm). Air and fluid filled duodenal diverticulum.
Calcified liver granulomas. Subcentimeter hypodense right kidney lesions too small to definitively characterize on CT but likely cysts.
2.7cm x 2.2cm x 3.0cm left adnexal mass, possibly ovarian in origin although the left ovary is not identified.
Case Discussion
HH containing stomach may result in gastric volvulus, which in turn presents as intestinal obstruction and may result in ischemia/infarction.
The stomach does not appear volved on this study.
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