A Case of Unilateral Hyperlucency on Chest X-Ray- A Diagnostic Dilemma

Unilateral hyperlucency of the lung is not an uncommon finding which arises from a variety of conditions, like technical, congenital and acquired. Here, the author presents a case of diaphragmatic hernia which presented as unilateral hyperlucency on chest radiography. A 45-year-old female, presented with complaint of shortness of breath for 2-3 years, increased since 15 days and pain in abdomen for 2-3 years. She consulted a doctor where a chest X-ray was done and was advised Intercostal tube insertion with the diagnosis of left-sided pneumothorax and was referred to us for further management. Instead of her vitals were stable on examination. On auscultation, breath sounds were of decreased intensity. A chest X-ray was then done which showed unilateral hyperlucency of the left side with the presence of air fluid level. The CECT thorax showed a large diaphragmatic hernia through which the large intestine and stomach were occupying the left hemithorax. Therefore, a thorough evaluation should be done before reaching a definitive diagnosis in such patients.