Radiological Case of the Month

A previously well 5-month-old male infant presented to the emergency department with a one-day history of cough and choking with feedings. There were several episodes of retching without emesis. On physical examination, the patient was in no distress and vital signs were normal. Auscultation of the lungs revealed the previously well 5-month-old male infant presented to the emergency department with a one-day history of cough and choking with feedings. There were several episodes of retching without emesis. On physical examination, the patient was in no distress and vital signs were normal. Auscultation of the lungs revealed the

Denouement and Discussion 

Intrathoracic Stomach With Volvulus  The initial chest roentgenograms (Figs 1 and 2) showed a large, intrathoracic, gas-filled viscus (stomach) located immediately above the diaphragm in the mediastinum. An upper-gastrointestinal-tract study confirmed the presence of an intrathoracic stomach and documented an associated 180° organoaxial volvulus of the stomach with herniation through the diaphragmatic hiatus. The pylorus is located at the