Diagnostic challenges of hiatal hernia Type IV: An imaging perspective

Type IV hiatal hernia is a mixed type of hiatal hernia characterized by the herniation of visceral organs other than the stomach into the mediastinum. It is the least common type of hiatal hernia. We report a case of a 4-month-old male infant who presented with shortness of breath and persistent vomiting. Initial chest X-ray suggested a mediastinal mass, but further evaluation with chest computed tomography (CT) scan revealed herniation of the stomach and duodenum through the hiatal oesophagus into the thoracic cavity. Radiological imaging was crucial in confirming the diagnosis of hiatal hernia.