Massive right-sided hiatal hernia variation

During routine cadaver dissection for academic purposes, a massive hiatal hernia was identified in an 84- year-old female cadaver. A herniation of abdominal contents was displaced into the right thoracic cavity, which contained the entire stomach, pyloric sphincter and portions of the greater and lesser omentums. Prior to death, there were no reports of significant functional abnormalities, although there were reports of gastrointestinal bleeding.

This case presents a rare variant due to two factors: the size of the esophageal hiatus and the displacement of the hernia into the right side of the thoracic cavity. The hiatal surface area (HSA) in this case report was calculated to be almost three times the established average HSA in normal patients. The majority of reported paraesophageal hernias (PEH) are left-sided with little mention of right-sided PEH in the literature. This case report attempts to add to the body of literature detailing right-sided hiatal hernias.