Diaphragmatic Hernia Causing Lung Collapse
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A 54-year-old man with a history of cerebral palsy and mental impairment presented with acute respiratory distress. He was afebrile and had a nonproductive cough. Physical examination revealed the use of accessory muscles of ventilation, decreased right hemithorax expansion, and an absence of breath sounds in the right hemithorax, with audible bowel sounds. The patient had mild hypoxia. A chest radiograph showed near-complete opacification of the right hemithorax, with gas-filled bowel loops on the right that extended to the level of the aortic arch. A radiograph obtained approximately 3 months before presentation had shown a small right diaphragmatic hernia...

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