Abstract
In this case report, we described a 74-year-old female patient with major complaint of respiratory problemsdyspnea after meal. Chest X-ray of the patient revealed a  gianttype IV hiatal hernia. Preoperative evaluations of the patient included esophagoscopy, esophageal manometry, barium swallow, and CT-scan. Repair of the hernia was performed using a dual mesh on the diaphragm and partial anterior fundoplication (Dor fundoplication). After a six-month follow-up, the overall condition of the patient  is satisfactory,  exceptmild intermittent dysphagia due to esophageal dysmotility.
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