title: Prenatal sonographic diagnosis of congenital hiatal hernia.
abstract: OBJECTIVE
  To report a rare case of congenital hiatal hernia illustrating the importance of its prenatal diagnosis as well as to discuss the prenatal sonographic criteria.
  
  
  METHODS
  A case of congenital hiatal hernia was diagnosed by ultrasound at 33 weeks of gestation. After a normal second-trimester morphologic ultrasound examination, a hypoechogenic mass was detected in the posterior mediastinum juxtaposed to the vertebral body and seemed to be in continuity with the intra-abdominal stomach bubble. Congenital hiatal hernia was suspected mainly because of the dynamic position of the stomach during the examination, without mediastinal shift, and normal appearance of the diaphragm on parasagittal sections of the thorax. Postnatal management was planned with no urgency and surgery was successfully performed, confirming the diagnosis.
  
  
  CONCLUSIONS
  This rare case illustrates the importance of prenatal diagnosis of congenital hiatal hernia for prenatal counseling and postnatal management. The ultrasound criterion for prenatal diagnosis is the presence of a herniated stomach in the posterior mediastinum, sometimes having a dynamic position during examination, with no mediastinal shift associated with normal diaphragm appearance on parasagittal sections of the thorax.
authors.affiliation: Maternité, Hôpital Necker-Enfants Malades, AP-HP Université de Paris V, Paris, France. rodrigoruano@hotmail.com
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ruano
authors.forename: Alexandra
authors.initials: A
authors.lastname: Benachi
authors.forename: Marie-Cecile
authors.initials: MC
authors.lastname: Aubry
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bernard
authors.forename: Fréderic
authors.initials: F
authors.lastname: Hameury
authors.forename: Claire
authors.initials: C
authors.lastname: Nihoul-Fekete
authors.forename: Yves
authors.initials: Y
authors.lastname: Dumez
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D006551:Hernia, Hiatal / Q000151:congenital / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D016216:Ultrasonography, Prenatal