A Case of Tension Pyopneumothorax Mimicking as Gastric Herniation

Abstract

A 35-year-old non-smoker, labourer, admitted in our hospital with complaints of low-grade, intermittent fever with exertional dyspnoea for the last two months and left-sided pleuritic chest pain for one month. He had taken anti-tuberculous treatment in 2009 for pulmonary tuberculosis under directly observed treatment, shortcourse (DOTS) for six months and improved clinically. He had suffered a blunt trauma to the chest (right lateral) six months back before admission when a cow struck him with its hooves. On examination, the patient was afebrile with a mediastinal shift to the right. There was tympanic note in the upper part of bilateral hemithorax and stony dull note in the lower part with a horizontal upper border bilaterally with absent breath sound all over the areas.