Barium swallow and computed tomography (CT) scan in a patient with a type IV paraesophageal hiatus hernia

(A) A barium swallow showing the entire stomach within the chest (asterisk). The gastroesophageal junction (arrow) is above the diaphragm (arrowhead) and the first part of the duodenum (dashed arrow) is at the level of the diaphragm.
(B) A CT scan through the lower chest showing the herniated stomach (asterisk) and portions of the colon within the hernial sac in the chest (arrow).