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Open Access Publications from the University of California

An Elderly Woman with Gibbus Deformity and Physiologic Shock

  • Author(s): Sakai, Shuntaro
  • Hirayama, Yoji
  • Oki, Motoji
  • et al.
Creative Commons Attribution 4.0 International Public License

Physiological shock requires prompt diagnosis and treatment in the emergency department. We present a case of physiological shock in a 91-year-old woman resulting from obstruction of the left atrium and inferior vena cava by a giant esophageal hiatal hernia, identified using computed tomography imaging. The patient’s age and history, including diet and eating behavior (namely needing to lie down immediately after a meal), and kyphotic posture were important factors to consider in establishing the differential diagnosis. While rare, a giant esophageal hiatal hernia should be considered in the differential diagnosis of obstructive shock.

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