Hiatal Hernia

Chest X-ray Findings

Hiatal Hernia usually presents radiographically as a well-defined, rounded, retrocardiac opacity with an air-fluid level. In many cases of hiatal hernia, there will not be an air bubble below the left hemidiaphragm. This is a relatively expected finding considering that the stomach is no longer in its usual position.

Round Retrocardiac Opacity

Air-Fluid Level

Pitfalls

One pitfall to consider is that hiatal hernias can look similar to a retrocardiac lung abscess or another cavitary lesion, but it will change in size and shape between radiographs. Large hernias can shift the mediastinum to the right and result in a widening of the carinal angle. They can even give the appearance of cardiomegaly. In the radiograph above, the cardiac silhouette is distinctly visible within the confines of the hiatal hernia.

Video Lectures