GIANT PARAESOPHAGEAL HERNIA IN AN ASYMPTOMATIC OLD MAN - THE CASE FORMISDIAGNOSING

We describe the case of an asymptomatic 66 year-old man with a giant p araesophageal hernia including colonic migration into the chest, respo nsible for the appearance of a bilateral anterior mediastinal mass on the chest radiograph. We would like to emphasise that this radiologic pattern could lead to misdiagnosing, due to the bilateral air-fluid le vel in the chest, close to the heart, Pericardial (effusion, cyst), br onchogenic (cyst), as well as esophageal (diverticula) diseases should be considered in the differential diagnosis, although the paucity of symptoms in our patient makes all of these syndromes unlikely to occur , It should also be emphasised that the esophagram can help differenti al diagnosis between mediastinic organs responsible for the pattern sh own in the chest radiograph.