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Images in thorax
Stomach versus lungs: the case of a giant hiatal hernia
  1. Elaine Soon1,2,
  2. Craig Vickery3,
  3. Thomas Pulimood1
  1. 1Department of Medicine, West Suffolk NHS Trust, Bury St Edmunds, Suffolk UK
  2. 2Department of Medicine, Addenbrookes’ Hospital, Cambridge, UK
  3. 3Department of Surgery, West Suffolk NHS Trust, Bury St Edmunds, Suffolk UK
  1. Correspondence to Dr Elaine Soon, Department of Medicine, Box 157, Level 5, Addenbrookes’ Hospital, Cambridge, CB2 0QQ, UK; e_soon{at}

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A 92-year-old man presented in extremis with respiratory failure. His chest X-ray (CXR) (figure 1A) showed right lower zone opacification and an intrathoracic gastric bubble. Emergency CT showed a giant paraoesophageal hiatal hernia containing his stomach, spleen and transverse colon (figure 1B,C). Nasogastric drainage failed to decompress the stomach; which had undergone volvulus.

Figure 1

(A) Plain chest radiograph showing the presence of a stomach bubble within the thoracic cavity. (B) and (C) CT images showing the presence of …

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