Hiatus hernia CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

Chest CT scan may be helpful in the diagnosis of a hiatus hernia. Findings on CT scan suggestive of a hiatus hernia include retrocardiac air-fluid level and organs within the hernia sac.

CT scan

Chest CT scan may be helpful in the diagnosis of hiatus hernia. Findings on CT scan diagnostic of hiatus hernia include:^[1]^[2]^[3]^[4]
- Retrocardiac air-fluid level
- Organs within the hernia sac

Focal fat collection in the middle of the mediastinum:
- Omentum herniates via the phrenic-esophageal ligament
- May also see a growth in the fats surrounding the distal esophagus

Para-esophageal hernia via a widened esophageal hiatus:
- Visualise contents, length, orientation of herniated stomach inside the lower thorax
- Herniated contents lie adjoining to the esophagus

Widening of esophageal hiatus
Dehiscence of diaphragmatic crura (>15 mm)

References

↑ Fukazawa K, Furuta K, Adachi K, Shimura S, Kamiyama K, Aimi M, Ohara S, Kajitani T, Tsurusaki M, Kitagaki H, Kinoshita Y (2013). “Continuous imaging of esophagogastric junction in patients with reflux esophagitis using 320-row area detector CT: a feasibility study”. J. Gastroenterol. Hepatol. 28 (10): 1600–7. doi:10.1111/jgh.12267. PMID 23663082.
↑ Kim C, Ouyang W, Dass C, Zhao H, Criner GJ (2016). “Hiatal Hernia on Chest High-Resolution Computed Tomography and Exacerbation Rates in COPD Individuals”. Chronic Obstr Pulm Dis. 3 (2): 570–579. doi:10.15326/jcopdf.3.2.2015.0158. PMC 5559159. PMID 28848881.
↑ Kahrilas PJ, Kim HC, Pandolfino JE (2008). “Approaches to the diagnosis and grading of hiatal hernia”. Best Pract Res Clin Gastroenterol. 22 (4): 601–16. doi:10.1016/j.bpg.2007.12.007. PMC 2548324. PMID 18656819.
↑ Ouyang W, Dass C, Zhao H, Kim C, Criner G (2016). “Multiplanar MDCT measurement of esophageal hiatus surface area: association with hiatal hernia and GERD”. Surg Endosc. 30 (6): 2465–72. doi:10.1007/s00464-015-4499-9. PMC 4767697. PMID 26304104.

[pmid23663082-1] Fukazawa K, Furuta K, Adachi K, Shimura S, Kamiyama K, Aimi M, Ohara S, Kajitani T, Tsurusaki M, Kitagaki H, Kinoshita Y (2013). “Continuous imaging of esophagogastric junction in patients with reflux esophagitis using 320-row area detector CT: a feasibility study”. J. Gastroenterol. Hepatol. 28 (10): 1600–7. doi:10.1111/jgh.12267. PMID 23663082.

[pmid28848881-2] Kim C, Ouyang W, Dass C, Zhao H, Criner GJ (2016). “Hiatal Hernia on Chest High-Resolution Computed Tomography and Exacerbation Rates in COPD Individuals”. Chronic Obstr Pulm Dis. 3 (2): 570–579. doi:10.15326/jcopdf.3.2.2015.0158. PMC 5559159. PMID 28848881.

[pmid18656819-3] Kahrilas PJ, Kim HC, Pandolfino JE (2008). “Approaches to the diagnosis and grading of hiatal hernia”. Best Pract Res Clin Gastroenterol. 22 (4): 601–16. doi:10.1016/j.bpg.2007.12.007. PMC 2548324. PMID 18656819.

[pmid26304104-4] Ouyang W, Dass C, Zhao H, Kim C, Criner G (2016). “Multiplanar MDCT measurement of esophageal hiatus surface area: association with hiatal hernia and GERD”. Surg Endosc. 30 (6): 2465–72. doi:10.1007/s00464-015-4499-9. PMC 4767697. PMID 26304104.

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