Sonopath Forum

Hiatal hernia

Hello. This is Jasmine a 6 year old GS. She was at her regular clinic yesterday for ongoing vomiting where xrays were submitted to a radiologist. The interpretation was a possible hiatal hernia because of a soft tissue opacity in the thorax seen on 1 view. I do not have the xrays to post and have not seen them. Because of the ongoing vomiting she was hospitalized and we performed an abdominal US. The majority of the US was unremarkable however the stomach is in an odd position. The spleen appears cranial to the stomach.

I heard the possible diagnosis prior to US so there is a chance that I am creating things however it does appear “abnormal”

I am posting a trans and sag clip of what I believe shows the fundus of the stomach and spleen angled dorsally and possibly going beyond the diaphragm. I would love some opinions on the images. Thanks. Brent.

Comments

March 12, 2017 at 3:02 pm -

I agree that the stomach

I agree that the stomach looks to be in an odd position but you need to increase your depth and loook beyond the diapgram further more dorsal to the cvc. Here is a hiatal hernia on us from a pug and see where the fundus is and the angle to get? Could do a barium study as well.

Here are some d hernias form the search and a few other cases mixed in

http://sonopath.com/members/case-studies/search?text=diaphragmatic+hernia&species=All

tosullivan

March 12, 2017 at 4:12 pm -

Thanks For the quick

Thanks For the quick response!

i had several images of varying depths and always lost the image deeper to the diaphragm. We were sent a few of the X-rays and got the report.

The DDX was a “sliding hiatal hernia”.

I tried in standing position, through the ribs and always encountered reverberation and could not get a clear image. My thought was that it was near herniating but not actually herniating when imaged.

I asked my associate about barium but she indicated that her research showed that it would not be of much more value if it was a sliding hiatal hernia. Her research indicated fluoroscopy was the next step. I think we will try the barium.

Thanks. Brent