BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e6032 (Published 10 September 2012) Cite this as: BMJ 2012;345:e6032
  1. Richard J B Ellis, core medical trainee,
  2. Joanna Trelawny, consultant cardiologist ,
  3. Richard Hawkins, consultant radiologist
  1. 1Leighton Hospital, Crewe CW1 4QJ, UK
  1. rjbellis{at}doctors.net.uk

A 47 year old man presented with postprandial chest pain associated with rhythmic borborygmus in time with his pulse. He had been involved in a motor vehicle accident 12 months earlier, needing a short hospital admission in Norway. On examination, there were bowel sounds across the precordium. A computed tomogram of his chest showed herniation of the body of the stomach and transverse colon in the anterior pericardium. The patient underwent corrective surgery. Blunt trauma is a common cause of diaphragmatic laceration and herniation, although it is normally diagnosed during the acute event rather than a year later.


Cite this as: BMJ 2012;345:e6032


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