Clinical Practice and Cases in Emergency Medicine

Introduction: While abdominal pain is a common complaint in the emergency department (ED), it is key to obtain a diligent history and maintain a broad differential diagnosis. The development of exercise-induced diaphragmatic hernia is rare but can result in a high risk of morbidity and mortality.

Case Report: This is a case of a 24-year-old man who presented to the ED with acute-onset epigastric abdominal pain that began while performing “burpee” (squat thrust) exercises. Computed tomography of the abdomen and pelvis revealed diaphragmatic rupture with gastric herniation into the left hemithorax. The patient underwent emergent surgical intervention to reduce the intra-abdominal contents and repair the diaphragmatic defect.

Conclusion: There are no prior reports of diaphragmatic hernia due to burpee exercises in the emergency medicine literature. Consideration of exercise-induced diaphragmatic hernia is necessary due to the high morbidity of this condition.