RESUMO
Acute dyspnoea in the postoperative period requires quick consideration of all possible causes and implementation of the proper treatment. During the differential diagnostic process, other than the most common cardio-pneumological and otolaryngological reasons, we should consider a whole array of rare causes such as neuromuscular illnesses, renal failure, and gastrointestinal diseases. This case is an example of sudden onset of dyspnoea presenting in a 67 year old woman with COPD. The dyspnoea occurred in first postoperative day after open reduction of fracture of the femur. Onset of respiratory insufficiency symptoms and circulatory instability appeared suddenly and advanced quickly, as result of a large Morgagni type retrosternal hernia, requiring urgent thoraco-surgical intervention. In the long term, the effects of this operation were very good.