Objective:

Report a clinical case of a patient with necrosis and gastric perforation due to Bochdalek hernia.

Clinical case:

A 31-year-old male, previously healthy, whom in at first-level center was assessed for sudden respiratory distress and chest x-ray findings compatible with hemothorax, requiring the placement of a pleural seal and sending to the third-level to follow up. At the time of admission without data of hemodynamic instability, chest x-ray was evaluated and a suggestive image of gastric fundus was observed inside the left hemithorax; therefore, CT-scan was performed and the diagnosis of diaphragmatic hernia was confirmed, it was managed with emergency laparotomy, and a total gastrectomy was necessary. Two years after surgery the patient is asymptomatic.

Conclusion:

Bochdalek hernia is a congenital deffect in posterolateral diaphragmatic portion. It is a very rare disease in the adulthood. In most cases when it is found it is a surgical emergency that can lead to a fatal outcome, despite its low incidence it must be keep in mind to avoid these complications.