Mutual Door Blockage Sign [4] (Khedewy Sign): A Novel CT Imaging Indicator of Type III Hiatal Hernia

Type III hiatal hernias, or mixed paraesophageal hernias, involve both the gastroesophageal junction (GEJ) and part of the stomach herniating through the esophageal hiatus. We present a case of a 68-year-old male with symptomatic hiatal hernia in which coronal CT imaging revealed a unique anatomical configuration. The stomach and esophagus appear to converge within the hiatus in a manner resembling two individuals blocking each other at a doorway. We propose the term Mutual Door Blockage Sign [4]? (Khedewy Sign) to describe this configuration. This sign may assist radiologists and clinicians in identifying and differentiating complex hiatal hernias with greater clarity and diagnostic confidence.