Axial CT angiogram of the chest featuring a distorted mediastinal anatomy and pleural cavity due to a massive hiatal hernia. Retrosuperior displacement of the aorta (purple arrow) and inferior vena cava (red arrow) without compression of critical vasculature is appreciated, as the hiatal hernia with intra-abdominal contents (yellow outline) is seen protruding into the thorax. The intra-abdominal contents within the hiatal hernia include the pancreas and associated fat content (blue arrow) and stomach (green arrow).   