Intrathoracic omental herniation through the esophageal hiatus: Report of a case

We report herein an extremely rare case of intrathoracic omental herniation through the esophageal hiatus, In fact, according to our review of the lit erature, only eight of her cases have been reported, most of which were mis diagnosed as mediastinal lipoma after being identified as an intrathoracic mass. We report herein the ninth case of intrathoracic omental herniation t hrough the esophageal hiatus. A 54-year-old obese woman was admitted to our hospital for investigation of a chest roentgenographic abnormality. She wa s asymptomatic, and her physical examination and laboratory data were all w ithin normal limits. Her chest X-ray demonstrated a large, sharply defined mass, and a computed tomography scan of the thorax indicated a large medias tinal mass with fat density. A thoracotomy was performed under the diagnosi s of a mediastinal lipoma which revealed an encapsulated fatty mass, 10 x 7 .5 x 6 cm in size, that proved to be an omental herniation through the esop hageal hiatus. There was no herniation of the stomach or intestines into th e thorax. The esophageal hiatus was repaired after the omental mass and her nia sac had been resected, This case report serves to demonstrate that when ever a mass of fat density is recognized in the lower thorax, an omental he rniation should be borne in mind as a possible differential diagnosis.