Abstract
Gastro pleural fistula resulting from strangulation and perforation of the fundus in a diaphragmatic hernia in an adult is a rare entity. A 56-year-old male presented with severe dyspnea. Emergency chest X-ray showed left hydropneumothorax with mediastinal shift for which chest tube was placed. Patient improved symptomatically, but liquid food particles started coming through the intercostal chest tube. Gastroscope, contrast fluoroscope and computed tomography chest carried out to detect exact anatomical and pathological diagnosis. Investigations revealed intrathoracic location of the stomach and spleen. Laparoscopy and then midline laparotomy carried out. Fundus of the stomach and spleen were in left pleural cavity through the hernia Bochdalek. There was perforation of prolapsed stomach leading to pyopneumothorax; hence pus drained out through the chest tube and then food particles appeared in the water seal bag. The stomach and the diaphragm were successfully repaired after doing the splenectomy.
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