Abstract
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.
Highlights
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
A giant esophageal hiatal hernia should be considered in the differential diagnosis of obstructive shock. [Clin Pract Cases Emerg Med. 2019;3(4):432–433.]
Summary
Journal Clinical Practice and Cases in Emergency Medicine, 3(4) An Elderly Woman With Gibbus Deformity and Physiologic Shock 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.
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