An unusual diaphragmatic hernia with gastric perforation and sub-acute presentation

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Gastric perforation into the thoracic cavity through a diaphragmatic hernia is rare but, when it occurs, patients present in severe distress, with mortality approaching 50%. We present a unique case in which a fibrotic reaction between the stomach and the parietal pleura led to a subacute presentation upon perforation. The extra time that this afforded led to more effective multidisciplinary team management and ultimately an excellent outcome for the patient.

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