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Traumatic diaphragmatic herniation presenting as a delayed tension faecopneumothorax
  1. M J Ramdass,
  2. S Kamal,
  3. A Paice,
  4. B Andrews
  1. Department of General & Vascular Surgery, Medway Maritime Hospital, Gillingham, Kent, UK
  1. Correspondence to:
 M J Ramdass
 Department of Vascular Surgery, Medway Maritime Hospital, Gillingham, Kent ME7 5NY, UK; jimmyramdass{at}


This article reports an unusual case of delayed presentation of a tension faecopneumothorax after traumatic injury to the diaphragm 5 years previously. Three important clinical lessons are highlighted: (a) for suspected tension pneumothorax, if a considerable quantity of serous fluid is drained in addition to air, a communication with the peritoneal cavity should be considered; (b) spontaneous tension pneumothorax is an extremely rare condition and other causes should be kept in mind; and (c) in the presence of a tension pneumothorax and diaphragmatic hernia, the contents of the visceral sac may be completely reduced and the hernia may be masked.

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  • Competing interests: None declared.

  • Informed patient consent was obtained.