Hiatal Hernia-induced Dyspnea in a Patient with Ascites: Leveraging Point-of-care Ultrasound for Accurate Diagnosis

Abstract

Abstract A hiatal hernia (HH) is characterized by the protrusion of the stomach or other abdominal viscera into the mediastinum. The mechanism of increased intra-abdominal pressure is typically associated with this condition. When there are additional contributing factors causing increased abdominal pressure, like ascites resulting from chronic liver disease, it can exacerbate HH symptoms, including dyspnea. The incorporation of point-of-care ultrasonography as an integral component of physical examination enables a precise and objective assessment of dyspnea offering physicians additional clues regarding the underlying etiology. We present a case of a patient who was admitted to the emergency department due to dyspnea and ascites. Through the utilization of point-of-care ultrasound, the diagnosis of an HH was made, identifying it as one of the factors contributing to the patient’s shortness of breath.