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Gastric volvulus and tension gastrothorax secondary to spontaneous transdiaphragmatic intercostal hernia
  1. Simon Bennet1,
  2. Michael Wang2,
  3. Calista Spiro3 and
  4. Chek Tog3
  1. 1Surgery, Austin Health, Heidelberg, Victoria, Australia
  2. 2Radiology, Austin Health, Heidelberg, Victoria, Australia
  3. 3Upper Gastrointestinal Surgery, Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia
  1. Correspondence to Dr Simon Bennet; simonjxbennet{at}


Spontaneous transdiaphragmatic intercostal hernia is an extremely rare clinical entity featuring dual defects in the diaphragm and chest wall. We report on the case of a 59-year-old man who developed a large left-sided hernia secondary to the minor trauma of a coughing fit. The hernia subsequently enlarged over the course of 3 years until it contained the stomach, leading to a gastric volvulus and tension gastrothorax with secondary pneumothorax. A subtotal gastrectomy was performed with Roux-en-Y reconstruction, and he made a full recovery.

  • gastrointestinal surgery
  • general surgery

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  • Contributors All authors reviewed and approved the final draft. SB: reviewof literature, draft, acquisition of data, agree to be held accountable for data. CS: conception and design, revising critically, final approval, agree to be heldaccountable. MW: review of radiography, revising critically, final approval, agree to be heldaccountable. CT: conception and design, revising critically, final approval, agree tobe held accountable.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.