PMC8286180_01
Upright chest X-ray showing large intrathoracic hiatal hernia between the yellow arrows.
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fig1
An 88-year-old female with a past medical history of gastroesophageal reflux disease, hypertension, and anxiety presented to the emergency department with nausea and abdominal pain after chest X-ray and CT (computed tomography) scan of the abdomen performed at an outside facility showed a large hiatal hernia with possible volvulus or gastric obstruction (Figures 1-3) at an outside facility.
Transverse chest CT of the abdomen showing large hiatal hernia with concern for gastric volvulus or gastric outlet obstruction. The large hernia is between the yellow arrows. The heart is "H," and the debris in the bowel is "D."
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fig2
An 88-year-old female with a past medical history of gastroesophageal reflux disease, hypertension, and anxiety presented to the emergency department with nausea and abdominal pain after chest X-ray and CT (computed tomography) scan of the abdomen performed at an outside facility showed a large hiatal hernia with possible volvulus or gastric obstruction (Figures 1-3) at an outside facility.
Coronal CT of chest and abdomen showing the large hiatal hernia located above the diaphragm with the liver "L" apparent.
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fig3
An 88-year-old female with a past medical history of gastroesophageal reflux disease, hypertension, and anxiety presented to the emergency department with nausea and abdominal pain after chest X-ray and CT (computed tomography) scan of the abdomen performed at an outside facility showed a large hiatal hernia with possible volvulus or gastric obstruction (Figures 1-3) at an outside facility.
12-lead EKG showing complete heart block.
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fig4
Surgical intervention was planned to correct the anatomical defect, but the day prior to her planned surgery, she ate a large meal and became hypotensive, with her 12-lead ECG showing complete heart block (Figure 4).
12-lead EKG obtained after NG tube placement and patient reverting back to normal sinus rhythm.
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fig5
She had a nasogastric tube inserted for decompression, which converted the complete heart block back to normal sinus rhythm (Figure 5).