Presentation
Central chest pain.
Patient Data
Age: 50 years
Gender: Male
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/83794/annotated_viewer_json?_c=1669422504\u0026lang=us"}
A single loop of colon and the dilated stomach with an air-fluid level are located in the mediastinum representing a massive diaphragmatic hernia. No evidence of pneumomediastinum.
Case Discussion
The stomach was decompressed with a gastric tube with good effect and the patient underwent a semi-elective diaphragmatic repair which found a large left diaphragmatic tear. The patient subsequently gave a history of significant childhood trauma (dirtbike accident) in a rural setting with little medical intervention.