Question: A 63-year-old woman was admitted to the emergency room for vomiting and abdominal pain localized in the epigastric region for the past 48 hours. Past medical history included ulcerative colitis, arterial hypertension, and asthma. Four months before admission, she had complained of occasional episodes of epigastric pain and had undergone an esophagogastroduodenoscopy (EGD) that had revealed a parahiatal hernia with an intrathoracic fundus and gastric corpus. She had a computed tomography scan that an revealed immense hiatal hernia, without signs of torsion.