Delayed Diagnosis of Left-Sided Diaphragmatic Hernia in an Elderly Adult with no History of Trauma

Reddy, Goutham Katukuri and Madireddi, Jagadesh and Agarwal, Sumit and Kareem, Hashir and Devasia, Tom (2016) Delayed Diagnosis of Left-Sided Diaphragmatic Hernia in an Elderly Adult with no History of Trauma. Journal of Clinical and Diagnostic Research, 10 (4). pp. 4-5. ISSN 0973-709X

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Abstract

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.

Item Type: Article
Uncontrolled Keywords: Acquired diaphragmatic hernia; Pneumonic consolidation; Pleural effusion
Subjects: Medicine > KMC Manipal > Cardiology
Medicine > KMC Manipal > Medicine
Depositing User: KMC Library
Date Deposited: 15 Mar 2017 07:01
Last Modified: 15 Mar 2017 07:01
URI: http://eprints.manipal.edu/id/eprint/148464

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