Giant Paraesophageal Hernia Presenting With Dyspnea: A Case Report With Surgical Considerations

TL;DR

A case report describes an elderly patient with a rare giant paraesophageal hernia causing breathing difficulties, successfully treated with minimally invasive surgery.

Contribution

Highlights the atypical presentation of giant paraesophageal hernias as a cause of dyspnea and the effectiveness of laparoscopic repair.

Findings

Giant paraesophageal hernias can present with dyspnea due to mechanical compression.

Laparoscopic hiatal hernia repair with fundoplication was effective in this case.

Early recognition and surgical intervention are crucial for optimal outcomes.

Abstract

Giant paraesophageal hernias (PEH) are uncommon and primarily affect older adults. While gastroesophageal reflux disease (GERD) symptoms are the most frequent presentation, some patients develop atypical manifestations, such as dyspnea, due to mechanical compression and impaired diaphragmatic function. We present the case of an elderly patient with a giant type IV PEH who underwent successful laparoscopic hiatal hernia repair with fundoplication. Her postoperative course was uneventful, highlighting the effectiveness of minimally invasive techniques. While surgical repair remains the gold standard for symptomatic and complicated PEH, recurrence remains a concern, necessitating ongoing refinements in surgical strategies. This report reinforces the importance of considering PEH in the differential diagnosis of dyspnea and the role of early recognition and timely surgical intervention in optimizing outcomes.

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