Figure 2.

Status postrepair of paraoesophageal hernia, concern for leak. (a) Frontal radiograph from an UGI series with water soluble oral contrast demonstrates smooth passage of contrast into the stomach with no extraluminal contrast leak into the mediastinum or pleural space. Axial images of chest CT with oral contrast (b, c) repeated due to continued concern for leak showed extravasation of oral contrast into the hernia sac (arrows). Note the presence of large volume air and fluid in the hernia sac. Teaching point. This case emphasizes the importance of proceeding with CT in patients with initial negative UGI study, especially when there is continued concern for leak. UGI, upper gastrointestinal.