Chest X-ray (Reflux)
Thorax x-ray in a child with recurrent respiratory infections.
The right limit of a round and clear shadow projects next to the right auricle of the heart.
The air-filled rounded shadow is an epiphrenic pouch of the stomach in a hiatus hernia. The gastroesophageal reflux combined with hiatus hernia explains the recurrent respiratory infections of the patient. The combination of such a history with the described incidental radiological finding is pathognomonic for hiatus hernia.
The differential diagnoses of the radiological findings include a right Morgagni hernia
(compare congenital diaphragmatic hernia in the chapter 'respiratory distress syndrome').
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