CTICasesTraumatic Hiatal Hernia
Imaging findings
CT in a 63-year-old male with a history of trauma 30 years prior shows a massive hiatal hernia containing the stomach, transverse colon, and pancreas in the chest. Coronal and sagittal reformats demonstrate a large defect with thickening of the diaphragmatic crus (dangling diaphragm sign).
Key takeaways
Severe blunt trauma can cause acute or delayed diaphragmatic rupture. In some cases, the injury results in dramatic enlargement of the esophageal hiatus itself, leading to chronic intrathoracic herniation of abdominal organs.
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