Yoshihiro Nagatake¹, Raiki Tokutsu¹, Noriko Tanaka¹, Chihiro Maekawa¹, Ayaka Tashiro¹, Masashi Kato¹, Youichi Yanagawa^1,

A 95-year-old female resident of a care facility with mild dementia had recently become unable to consume solid food and was primarily maintained on a liquid diet. After lunch, she suddenly became aphonic, reportedly due to abdominal discomfort. During transport to the hospital by ambulance, she vomited once. Upon arrival, she appeared visibly distressed, although her vital signs remained stable. Prior to undergoing a computed tomography (CT) scan, she exhibited persistent nausea. CT imaging of the torso revealed a hiatal hernia involving the stomach, with impaction of the distal portion. Notably, the patient's pain resolved spontaneously following the CT examination. She was admitted for observation and subsequently discharged back to the care facility. Despite a thorough literature search, no similar cases were identified. We hypothesize that this phenomenon may have been caused by herniation of the posterior half of the stomach, potentially due to gastric elongation (gastroptosis) or increased mobility of the duodenum, rendering the posterior gastric wall more susceptible to displacement. This rare case may represent an unreported variant in the spectrum of sliding hiatal hernias.

hiatus hernia, distal stomach, aging