A case of giant hiatal hernia in an elderly patient: When stomach, duodenum, colon, and pancreas slide into thorax

Although the incidences of hiatal hernias increase with age, respiratory symptoms caused by hiatal hernias remain extremely uncommon. We report a case of an 88-year-old female who presented with 2-months of progressive shortness of breath. Upon arrival, the patient was found to be hypoxic with oxygen saturation 90% on room air. Physical examination also showed decreased breath sounds on left basal lungs and bilateral crackles at basal lungs. Plain radiograph demonstrated an increased opacity at the left lower lobe. Subsequent computerized tomography of the chest revealed a giant hiatal hernia, containing stomach, proximal duodenum, colon, and pancreas. This case highlights the giant hiatal hernia as an unusual cause of shortness of breath, especially in elderly patients.