Delayed diagnosis of left-sided diaphragmatic hernia in an elderly adult with no history of trauma

Goutham Reddy Katukuri, Jagadesh Madireddi, Sumit Agarwal, Hashir Kareem, Tom Devasia

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6 Citations (Scopus)


Diaphragmatic Hernia (DH) is the herniation of abdominal contents into the thorax through a rent in the diaphragm. Acquired DH most commonly occurs following a blunt or penetrating trauma to the abdomen with former being common than the later. Very rarely DH can be spontaneous and be asymptomatic until it’s very extensive. A 78-year-old presented with breathlessness and chest pain of one month duration. There was dull note to percussion and absent breath sounds in left lower zone. Auscultation revealed bowel sounds in left infra-axillary and mammary area. Electrocardiogram and laboratory data suggested acute myocardial infarction. Coronary angiogram showed a triple vessel disease. Roentgenogram was simulating pneumonic consolidation but presence of air shadows was the thing against pneumonic consolidation. CT imaging of the thorax revealed an extensive left diaphragmatic hernia with viscera and left kidney as its contents. He was initially taken up for CABG and surgery for diaphragmatic hernia was planned at a later date. This case is important for its extensive nature and for its rarity as acquired DH rarely occurs spontaneously. Chest roentgenogram must be read cautiously in all such cases to look for this entity. Auscultation for bowel sounds in the thorax is a diagnostic clue.

Original languageEnglish
Pages (from-to)PD04-PD05
JournalJournal of Clinical and Diagnostic Research
Issue number4
Publication statusPublished - 01-04-2016

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Clinical Biochemistry


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