TITLE:
Mutual Door Blockage Sign [4] (Khedewy Sign): A Novel CT Imaging Indicator of Type III Hiatal Hernia
AUTHORS:
Ahmed Khedewy Ahmed
KEYWORDS:
Hiatal Hernia, Type III Hernia, CT Imaging, Khedewy Sign, Mutual Door Blockage, Radiology Case Study
JOURNAL NAME:
Open Journal of Radiology,
Vol.15 No.3,
September
2,
2025
ABSTRACT: Type III hiatal hernias, or mixed paraesophageal hernias, involve both the gastroesophageal junction (GEJ) and part of the stomach herniating through the esophageal hiatus. We present a case of a 68-year-old male with symptomatic hiatal hernia in which coronal CT imaging revealed a unique anatomical configuration. The stomach and esophagus appear to converge within the hiatus in a manner resembling two individuals blocking each other at a doorway. We propose the term Mutual Door Blockage Sign [4]? (Khedewy Sign) to describe this configuration. This sign may assist radiologists and clinicians in identifying and differentiating complex hiatal hernias with greater clarity and diagnostic confidence.