Giant Hiatal Hernia Caused by Chronic Constipation in an Elderly Patient

On physical examination, her vital findings were as follows: blood pressure: 128/68 mm Hg, the pulse rate: 98 beats per minute, oxygen saturation on room air: 92%, and body temperature: 36.9o Celsius. Gastric volvulus, obstruction, and infarcts lead to life-threatening situations in type II and III hernias (10). Since the frequently herniated organ is the transverse colon, it may cause chronic constipation due to its obstruction and clinical manifestations requiring emergency surgical interventions (11). Computed thoracoabdominal tomography is extremely useful in determining the width of the defect in large Type 4 HHs, as well as in detecting organs within the hernia and in demonstrating other intra-thoracic and intra-abdominal pathologies. Since there was no pathology in these two tests, control thoracoabdominal computed tomography was performed in the patient known to have a HH, and hernia characteristics were re-evaluated. The first-line treatment for a patient presenting with typical GERD symptoms is a double-dose proton pump inhibitor (12).