title: Left Sided Hydro-pneumothorax in a Operated Case of Left Diaphragmatic Hernia Repair: A Diagnostic Dilemma.
abstract: Diaphragmatic hernia in adults often presents with overlapping respiratory and abdominal symptoms. They may be simple diaphragmatic eventrations or undiagnosed Bochdalek's hernias or may even be of post traumatic variety. Diaphragmatic hernias may be asymptomatic, present only with respiratory symptoms, or may present with obstruction and strangulation of involved bowel loops with faeco-pneumothorax. The index case was operated for open diaphragmatic hernia repair six years back and admitted for breathlessness with absence of abdominal signs and symptoms. Patient subsequently developed hydro-pneumothorax during conservative management. Emergency laparotomy revealed a gastric ulcer which perforated into the left chest giving rise to hydro-pneumothorax. In present study we would like to report how this unusual presentation led to dilemma in diagnosis and surgical intervention thus increasing the morbidity and mortality of the patient at our institute.
authors.affiliation: Resident, Department of General Surgery, Government Medical College Miraj and P.V.P. Government Hospital , Sangli, Maharashtra, India .
authors.forename: Chandrakant Kamlesh
authors.initials: CK
authors.lastname: Pancholi
authors.affiliation: Associate Professor, Department of General Surgery, Government Medical College Miraj and P.V.P. Government Hospital , Sangli, Maharashtra, India .
authors.forename: Narendra Narayan
authors.initials: NN
authors.lastname: Hombalkar
authors.affiliation: Associate Professor, Department of General Surgery, Government Medical College Miraj and P.V.P. Government Hospital , Sangli, Maharashtra, India .
authors.forename: Santosh Bhimrao
authors.initials: SB
authors.lastname: Dalvi
authors.affiliation: Professor and Head, Department of General Surgery, Government Medical College Miraj and P.V.P. Government Hospital , Sangli, Maharashtra, India .
authors.forename: Prakash Dattatray
authors.initials: PD
authors.lastname: Gurav
keywords: Bilious hydro pneumothorax; Gastric ulcer perforation; Recurrent diaphragmatic hernia