A 25-year-old man presented with upper abdominal pam and respiratory distress lasting for 4 days. On initial evaluation, he was having mild tenderness in the epigastrium and reduced air entry on the left side of the chest. A succussion splash was heard on the left side of chest. A chest x-ray showed tension hydropneumothorax on the left side (Figure 1). In view of respiratory distress, an intercostal drain was inserted on the left side of the chest. The chest tube did not drain pleural fluid. The next day, a 64-slice computed tomography scan of the chest was done that showed a Bochdalek hernia with the stomach, colon, and left lobe of the liver in the thorax. The patient underwent operation, and at laparotomy the Bochdalek hernia was seen on the left side of the diaphragm posteriorly. The stomach, splenic flexure of colon, and left lobe of the liver were seen passing through the hernia into the thorax.
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