{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T10:00:42Z","timestamp":1756461642648,"version":"3.44.0"},"reference-count":12,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,6,17]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:p>A 78-year-old man with no surgical history or recent trauma presented to the emergency department with sudden onset right-sided chest pain and dyspnoea. He was admitted under the physicians for investigations and was subsequently diagnosed with empyema of the right thorax. After no improvement with intravenous antibiotics, a chest drain was inserted; no pus was drained. He worsened clinically; a repeated CT scan demonstrated an incarcerated loop of small bowel within the right thoracic cavity secondary to a diaphragmatic hernia (DH). The patient had emergency surgery to remove necrotic small bowel and to lavage the thorax. Strangulated DH should be considered as a differential diagnosis where presentation is unusual and empyema does not improve after initial management.<\/jats:p>","DOI":"10.1136\/bcr-2019-233440","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T02:15:14Z","timestamp":1594260914000},"page":"e233440","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Strangulated right-sided diaphragmatic hernia presenting and treated as lung empyema: beware of the differential diagnosis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8436-2858","authenticated-orcid":false,"given":"Sapna","family":"Gupta","sequence":"first","affiliation":[{"name":"Royal Gwent Hospital, Newport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Warrell","sequence":"additional","affiliation":[{"name":"Royal Gwent Hospital, Newport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurie","family":"Smith","sequence":"additional","affiliation":[{"name":"Royal Gwent Hospital, Newport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gethin Llewellyn","family":"Williams","sequence":"additional","affiliation":[{"name":"Royal Gwent Hospital, Newport, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,7,8]]},"reference":[{"key":"2025082707080815000_13.7.e233440.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)65126-0"},{"key":"2025082707080815000_13.7.e233440.2","doi-asserted-by":"crossref","first-page":"691","DOI":"10.2147\/TCRM.S135677","article-title":"Unusual delayed presentation of diaphragmatic hernia complicated by transverse colon and total small-bowel obstruction after postoperative chemotherapy of esophageal cancer","volume":"13","author":"Sun","year":"2017","journal-title":"Ther Clin Risk Manag"},{"key":"2025082707080815000_13.7.e233440.3","doi-asserted-by":"crossref","unstructured":"Callister ME , Lawrence H , Gill K , et al . 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