INCIDENTAL FINDING OF RIGHT-SIDED IDIOPATHIC SPONTANEOUS ACQUIRED DIAPHRAGMATIC HERNIA: A RARE CASE REPORT

Background: Diaphragmatic hernias are classified as congenital or acquired, with the latter typically resulting from traumatic or iatrogenic injuries. Spontaneous acquired diaphragmatic hernias without history of trauma or surgery are exceedingly rare, particularly on the right side due to the protective effect of the liver. This case emphasizes a unique presentation and management strategy for this uncommon clinical entity. An 83-year-old female presented with progres Case Presentation: sive shortness of breath, dry cough, chest discomfort, nausea, vomiting, and regurgitation of food. She had no prior incidents of trauma or surgical procedures. The initial clinical examination suggested pleural effusion. However, ultrasonography revealed a right-sided diaphragmatic tear with omental herniation into the right hemithorax. Computed tomography confirmed a large defect in the anteromedial aspect of the right hemidiaphragm with omental herniation causing compressive atelectasis of the middle and lower lobes of the right lung. Discussion: The patient underwent successful open surgical repair through a thoracoabdominal approach. This case is unusual due to its right-sided presentation in an elderly patient without trauma history, highlighting the diagnostic challenges associated with this condition and the importance of appropriate imaging. Conclusion: Spontaneous acquired diaphragmatic hernias represent a rare clinical entity requiring high clinical suspicion for diagnosis. Timely identification and suitable surgical treatment are essential to avert complications. This case underscores the necessity of recognizing diaphragmatic hernia as a potential cause of respiratory symptoms, even in the absence of traumatic injury