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Chest Imaging

E2775. Thoracic Hernias: Types, Imaging, Complications and Treatment

Croake A,  Chaturvedi A,  Chaturvedi A. University of Rochester Medical Center, Rochester, US

Address correspondence to A. Chaturvedi (forapeksha@yahoo.com)

Background Information: Thoracic hernias, both congenital and acquired, are fairly common. Though often clinically silent, strangulation or incarceration of these hernias mandate emergent surgical repair. Some, such as lung herniation are always surgically repaired, even if asymptomatic. Imaging is pivotal towards accurate identification and assessment of complications.

Educational Goals/Teaching Points: We will identify different types of thoracic hernias. Participants will learn the key diagnostic features and most appropriate imaging modality; e.g., prenatal MRI for congenital diaphragmatic hernias, after IV contrast material administration for midline sternal dehiscence, after oral contrast material administration for hiatal hernia with volvulus. Participants will learn the complications associated with these hernias, and we will provide an overview of criteria for surgical repair.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: Types of thoracic hernias include congenital (diaphragmatic, thoracic inlet associated with cervical aortic arch, Morgagni, and Bochdalek) and acquired (hiatal hernia, posttraumatic diaphragmatic hernia, intercostal lung hernia, sternal dehiscence such as incisional hernia of the right ventricle). Diagnostic modalities to be presented include radiography, fluoroscopy, CT, and MRI. The exhibit will also discuss complications and criteria for surgical repair.

Conclusion: Accurate identification of hernias and complications can be performed on imaging. It is necessary to avoid confusion with potential mimics.