ABSTRACT
Congenital right sided intra-thoracic hiatal hernia is an uncommon clinical entity consisting of herniation of a viscous through congenitally abnormal esophageal hiatus into an intra-thoracic location. Is to present the diagnostic challenge and the surgical management of eight cases of this uncommon congenital anomaly admitted during asix years period [2000 - 2005] to the medical city teaching complex in Baghdad. Iraq and to compare the study with other international studies. Eight patients were studied retrospectively in details as regard the age, sex, clinical manifestations, radiological findings. Details of the operative findings and the surgical outcome. All the patients had right sided intra-thoracic abdominal organ herniation mostly the stomach, all the patients ahad large hiatus, the patients were managed successfully through laparatomy with uneventful postoperative course. This uncommon variety of the congenital hiatal hernia presented a diagnostic challenge to the pediatrician, pediatric surgeon and the thoracic surgeon .Laparatomy was the procedure of choice and adding an anti -reflux procedure is highly indicated