Large Paraesophageal Hiatus Hernia with Organoaxial Gastric Volvulus Causing Pulmonary Compromise: A Case Report

Paraesophageal hiatus hernias are an uncommon subtype of hiatal hernias but carry a significant risk of lifethreatening complications such as gastric volvulus, obstruction, and ischemia. We present the case of a 63-year-old female who presented with acute gastrointestinal and respiratory symptoms. Imaging revealed a large right-sided paraesophageal hernia with organoaxial gastric volvulus and intrathoracic migration of the stomach, resulting in compression of the right lung. Endoscopic reduction attempted but was not successful. The patient underwent successful laparoscopic reduction, crural repair, and fundoplication, with favorable postoperative recovery. This case highlights the importance of early recognition, the role of advanced imaging in diagnosis, and the effectiveness of minimally invasive surgical management in preventing morbidity and mortality.