A CASE OF ESOPHAGEAL HIATAL HERNIA WITH GREATER OMENTUM MIMICKING LIPOMA OF THE POSTERIOR MEDIASTINUM

Abstract

A 49-year-old woman was admitted to the hospital because of chest pain. A chest X-ray film showed a post-cardial mass shadow and a chest CT scan and magnetic resonance imaging revealed a 14.5×8cm fatty mass of the posterior mediastinum. Because the tumor was large and the patient had complained of chest symptoms, we performed an operation under a diagnosis as lipoma of the posterior madiastinum. At the operation, it was revealed that the fatty mass was the herniated greater omentum through an esophageal hiatus. We put the omentum back to the peritoneal cavity and repaired the esophageal hiatus.
Postoperative course was uneventful. The patient was discharged from the hospital on the 7th hospital day. As of eight months after the operation, there have been no relapse of the disease. Esophageal hiatal hernia with the greater omentum has been rarely reported. In case of the fatty mass of the inferior posterior mediastinum, it is necessary to take this condition into consideration.