Muhammad Shoaib Hanif, Ahmed M.
Eventration of Diaphragm in an adult.
Pak J Surg Jan ;18(1):45-8.

A 45 years old female presented to the department of surgery, CMH Rawalpindi complaining of pain in the upper abdomen for the last two years and short ness of breath for one month. She was symptom free two years ago when she developed episodic pain in her upper abdomen. Each episode comprised an insidious vague burning pain that did not shift but radiated into the chest. It was aggravated after meals, lying down straight, stooping forwards and relieved by standing, lying propped up and, 2 to 3 hours after food. The episodes were occasional to begin with but in the month before presentation the pain came after every meal or when ever she lied down, grossly inter fering with her daily routine work. She was also experiencing an associated shortness of breath on accustomed exertion especially during the episodes of pain. There was no history of fever vomiting, haemetemesis, malaena, constipation or diarrhea. There was no history of cough, palpitations, angina like pain or any change of color of extremities. She had been receiving treatment for acid peptic disease for the last two years. Radiographic posteroanterior view of chest revealed that the stomach was displaced into the left lower chest suggestive of herniation through the diaphragm. Barium meal study of upper gastrointestinal tract was reported to have normal flow of contrast through esophagus.

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