Abstract
BACKGROUND: Spontaneous diaphragmatic hernia without a previously documented history of trauma is uncommon and clinical presentation can often be atypical ranging from an incidental radiological finding to patients presenting with complications. CASE PRESENTATION: In this video we present the case of a patient presenting with gastric perforation within a large spontaneous diaphragmatic hernia in the central part of the left hemidiaphragm. CONCLUSIONS: Management of a complicated diaphragmatic hernia could be achieved using laparoscopic approach. The rarity of these hernias means that the operative strategy necessary for safe dissection and repair has to be individualized for each patient.