Clinical Practice and Cases in Emergency Medicine
An Elderly Woman with Gibbus Deformity and Physiologic Shock
- Author(s): Sakai, Shuntaro
- Hirayama, Yoji
- Oki, Motoji
- et al.
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.