Gastric volvulus and tension gastrothorax secondary to spontaneous transdiaphragmatic intercostal hernia.

Spontaneous transdiaphragmatic intercostal hernia is an extremely rare clinical entity featuring dual defects in the diaphragm and chest wall. We report on the case of a 59-year-old man who developed a large left-sided hernia secondary to the minor trauma of a coughing fit. The hernia subsequently enlarged over the course of 3 years until it contained the stomach, leading to a gastric volvulus and tension gastrothorax with secondary pneumothorax. A subtotal gastrectomy was performed with Roux-en-Y reconstruction, and he made a full recovery.