Stomach versus heart: case report of a giant hiatal hernia with perforated gastric ulcer with obstructive shock

A giant paraesophageal hernia is defined when at least 30% of the stomach has moved to thorax or presence another intra-abdominal organ. We describe presentation a clinical case hiatal with perforated gastric ulcer in 52-year-old man who presented emergency department pain inguinal region developing obstructive shock. Presentation hernias usually asymptomatic and some cases atypical signs symptoms involving cardiovascular respiratory disorders. In patients history gastroesophageal reflux disease/ thoracic symptoms, its complications should be ruled out.