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An Elderly Woman With Gibbus Deformity and Physiologic Shock

Shuntaro Sakai, Yoji Hirayama, Motoji Oki

Clinical Practice and Cases in Emergency Medicine · 2019

doi:10.5811/cpcem.2019.6.42522 (opens in a new tab)

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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.

Abstract licence: CC BY

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