An 81-year-old woman presented with a 1-week history of vomiting. What is the diagnosis?

Answer D. Paraesophageal herniaThe correct answer is paraesophageal hernia. This chest x-ray and a subsequent CT scan showed a large retrocardiac mass containing air and fluid, consistent with herniation of the stomach into the chest. Paraesophageal (or hiatal) hernias occur when the stomach protrudes through the diaphragm into the chest. Hernias are classified by the degree of migration of the gastroesophageal junction and stomach.