A large hiatus hernia in the thoracic cavity is rare but can result in respiratory symptoms and signs such as shortness of breath, unilateral reduced breath sounds and even respiratory failure. This condition, also known as gastrothorax, can sometimes be very challenging to diagnose due to its resemblance with pneumothorax. Few cases have been reported when gastrothorax has been mistakenly identified as pneumothorax and attempts have been made for aspiration of air, resulting in stomach perforation.
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