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A 76-year-old woman presented to the emergency department with a 3 day history of continuous pain in the upper abdomen and multiple episodes of non-projectile vomiting. The patient was dehydrated and physical examination revealed a firm right parasternal bulge and epigastric tenderness. There was a large air-fluid level in the retrocardiac area on the chest radiograph (figure 1). CT abdomen revealed an anteromedial defect in …
Contributors SM: Case diagnosis, pictures, planning and manuscript preparation. AK: Literature search, manuscript editing. AkG: Review of literature, manuscript editing. AG: Case management, manuscript editing.
Competing interests None.
Patient consent Obtained.
Ethics approval UCMS and GTB Hospital.
Provenance and peer review Not commissioned; internally peer reviewed.
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