Sliding Hiatal Hernia
IMAGES 1-3: the intrathoracic part of the stomach (aka the "sliding hiatal hernia") in a plain CXR, without any contrast medium, missed by many colleagues preoperatively; there was no need for preop Ba Swallow (diagnosis confirmed by endoscopy twice preop)

IMAGES 4-7: the intrathoracic part of the stomach (aka the "sliding hiatal hernia") prior to being repaired

IMAGES 8-12: Post surgical Repair (Belsey Mark IV fundoplication)
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1. Preop plain CXR: look carefully behind the cardiac silhouette!

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2. The same preop CXR. Arrows: intrathoracic part of stomach, missed earlier by many

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3. Posterolateral preop CXR of the same case, as above (images 1-2-3: same clinical case)

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4. Preop Ba swallow: GREEN: hiatal hernia, YELLOW: intraabdominal stomach, BLUE: diaphragm

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5. Preop Ba swallow: GREEN: hiatal hernia, YELLOW: intraabdominal stomach, BLUE: diaphragm

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6. Intraoperatively the hiatal hernia aka the 'intrathoracic fundus of stomach' (BLUE). GREEN: oesophagus, YELLOW: diaphragm

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7. Intraoperatively the hiatal hernia aka the 'intrathoracic fundus of stomach' (BLUE). GREEN: oesophagus, YELLOW: diaphragm

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8. Intraoperatively Post repair: there is no longer any part of the stomach inside the chest (GREEN: oesophagus, YELLOW: diaphragm)

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9. Intraoperatively Post repair: there is no longer any part of the stomach inside the chest (GREEN: oesophagus, YELLOW: diaphragm)

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10. Intraoperatively Post repair: there is no longer any part of the stomach inside the chest (BLUE: oesophagus, YELLOW: the hiatus of the diaphragm)

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11. Postop radiologic image: there is no longer any intrathoracic stomach (BLUE: diaphragm, YELLOW: intraabdominal stomach)

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12. Postop radiologic image: there is no longer any intrathoracic stomach (BLUE: diaphragm, YELLOW: intraabdominal stomach)