Presentation
Central chest pain.
Patient Data
Age: 50 years
Gender: Male
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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.