Paraoesophageal hernia revealed by small pleural effusion

We report the case of a 79 year-old female with dry cough, exertional dyspneea, fatigue and possible small repeated haemoptysis in which Chest X-Ray revealed a mixed hydro-aeric image in the lower part of the left haemithorax. Differential diagnosis issues imposed further investigation conducting to a surprising and rare condition: paraoesophageal hernia. Barium swallow imaging and computed tompgraph scan, as well as digestive endoscopy confirm the diagnosis and specify the type and size of hiatal hernia. Laparoscopic surgery is recommended as a choice of treatment because of the high risk of complications and often high amount of herniated stomach in the chest, especially for patients younger than 65 years old.