PERFORATED PEPTIC ULCER IN A DIAPHRAGMATIC HERNIA : A RARESURGICAL EMERGENCY

Diaphragmatic hernia is a condition in which abdominal viscera herniates into the thorax. These diaphragmatic hernias may be congenital or may develop after blunt or penetrating thoracic trauma and these hernias may remain undiagnosed until patient become symptomatic. Most of the diaphragmatic hernias are discovered incidentally on chest x-ray or during endoscopy performed for some other disease. Here we are reporting a rare case of perforated gastric ulcer in a diaphragmatic hernia. Only few such cases are reported in medical literature. An elderly male presented with upper abdominal pain and was diagnosed as diaphragmatic hernia. Exploratory laparotomy revealed stomach entering into the thoracic cavity and one gastric perforation. Diaphragmatic rent was repaired with gastric perforation repair and left side intercostal drainage tube. Patient was discharged without any post operative complication, with successful outcome.