Diaphragmatic hernias are commonly congenital and usually present in childhood. In adults presentation may differ from being asymptomatic to presenting with life-threatening complications, like obstruction or strangulation. Hernias with omentum as content may be misdiagnosed as mass lesions. Chest radiograph helps in establishing the diagnosis only in one-third of cases as radiographic picture varies depending on the content of hernia. Although with the use of helical computed tomography (CT) the sensitivity of detection of diaphragmatic defects has increased considerably but magnetic resonance imaging due to its multiplanar imaging capability and superior soft tissue contrast is the most reliable diagnostic modality in cases with uncertain CT diagnosis. We report a case of an anterior diaphragmatic hernia presenting as a large homogeneous opacity in an adult female.
Spontaneous diaphragmatic hernia without any apparent predisposing factor is a very rare condition. We report a case of 28-year-old male who presented with complaints of abdominal pain and gradually increasing breathlessness. Chest radiograph was suggestive of left-sided hydropneumothorax. Diagnosis of diaphragmatic hernia was confirmed by computed tomography. The defect was repaired by open thoracotomy and patient had an uneventful postoperative recovery.
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