Chest radiograph unknown 5

Anshuman Bansal

JHU SOM

abansal1@jhmi.edu

David Marker

JHU SOM

dmarker@jhmi.edu

Publication Date: 2009-09-09

Findings

Look carefully at the AP and lateral chest x-ray of this patient. There is a structure in the chest that is abnormal.

1. Can you make a diagnosis here?

   a	Hiatal hernia Correct! Part of the stomach has herniated through the esophageal hiatus and is now in the chest. The air in the stomach ("stomach bubble") is visible in the chest.
   b	Lung cancer Incorrect. Although there does appear to be a mass in the left lung, the air fluid level within the mass indicates that it is unlikely to be a tumor.
   c	Pericardial effusion Incorrect. This is a good guess, however, there should not be a large amount of air ("stomach bubble"} visible in the pericardium.
   d	Cardiomegaly Incorrect. The heart is not enlarged in this image.