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rare case of an elderly patient with incidentally diagnosed spontaneous diaphragmatic hernia

Spontaneous acquired diaphragmatic hernia is a rare finding, which occurs in the absence of any history of surgery or trauma. We report a rare case of incidentally diagnosed spontaneous diaphragmatic hernia in an elderly female who came in emergency department for pathological intertrochanteric fracture. She had left ventricular ejection fraction 35% and mild mitral regurgitation. Surgical repair of diaphragmatic hernia was planned. But she developed respiratory distress and was shifted to intensive care unit for stabilization. We are mentioning the successful management of this elderly female with diaphragmatic hernia. This case explains the importance of physical examination and various considerations in patients with diaphragmatic hernia and low ejection fraction.