396.A 77-year-old woman complains to her doctor about left sided chest
pain, difficulty swallowing and the sensation that food is stuck in her
esophagus. Antacids don’t seem to help much. The symptoms seems to get
worse if she lies down shortly after meal and she often has some small
reflux of acidic stomach contents. A barium swallow study is performed
and one of the late images taken is illustrated below.
504 Anatomy, Histology, and Cell Biology
Based on the history and radiological image which of the following is
the most likely diagnosis?
a. Sliding hiatal hernia
b. Para esophageal hiatal hernia
c. Congenital Bochdalek hernia
d. Pylorospasm
e. Congenital hypertrophic pyloric stenosis
(Image 4910 used with permission from the Radiological Anatomy web site, University of
Kansas, School of Medicine, http://classes.kumc.edu/som/radanatomy/.))