An independent community-dwelling 85-year-old nonsmoking woman was admitted with shortness of breath and cough. Her history included hypertension, hypothyroidism, and episodic dyspnea treated by her primary physician as bronchial asthma. On examination, she appeared comfortable and was afebrile, with normal respiratory rate and oxygen saturation (97%). However, bilateral wheezing and rhonchi were heard, and decreased breath sounds on the left were noted. Heart rate was regular (85 beats per min), and her blood pressure 155/85 mm Hg without signs of heart failure. Laboratory tests were unremarkable, with pH 7.406 and normal PCO2/bicarbonate. Chest X-ray and computed tomography (Figure 1, Figure 2) revealed a giant left-sided hiatal hernia containing the entire stomach and much of the transverse and descending colon, compressing the lung and heart. Systemic steroids and inhaled bronchodilators were stopped as were antibiotics for pneumonia. Together with the patient, conservative treatment was preferred, and she was discharged home on omeprazole.
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Published online: June 06, 2022
Publication stageIn Press Journal Pre-Proof
Conflicts of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
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