HIATUS HERNIA

INTRATHORACIC STOMACH

A hiatus hernia is the herniation of intraabdominal organs, usually the stomach, through the esophageal hiatus of the diaphragm into the thoracic cavity.

A congenital hiatal hernia is associated with:

• Partial right intrathoracic stomach.
• Complete right intrathoracic stomach.
• Short esophagus.
• Rarely with an associated organoaxial tortion.

Prenatal diagnosis of a Hiatus Hernia has been reported (1), as well as Intrathoracic Stomach (2).

ULTRASOUND

• Prevertebral hypoechoic mass.
• Mass is contiguous with and communicates with an infradiaphragmatic stomach, or part of, or the entire stomach has herniated into the thoracic cavity.
• No mediastinal shift or pulmonary hypoplasia.
• No polyhydramnios.
• No pleural or pericardial effusion.
• No other structural abnormality or increased frequency of aneuploidy.

	(Curved arrow = Hiatus Hernia; Small arrow = gastric antrum; Arrow head = Heart)
	(L = Liver; H = Heart)

COMPLICATIONS IN UTERO

• Organoaxial tortion of the stomach may occur when a right intrathoracic stomach is present (does not occur with a simple hiatal hernia without intrathoracic stomach) (2).

ULTRASOUND

1. Bahado-Singh RO, Romero R, Vecchio M et.al. Prenatal diagnosis of congenital hiatal hernia. J Ultrasound Med 1992;11:297-300.
2. Haddad MC, Youssef BA, Sammak BM et.al. Right intrathoracic stomach secondary to congenital hiatal hernia and organoaxial tortion. AJR 1996;167:66-68.