A 15-Year-Old Female Presenting With Traumatic Diaphragmatic Hernia One Year After a Car Accident

Abstract

Traumatic diaphragmatic hernia (TDH) is a known complication in patients with abdominal injuries. Delayed TDH, which presents long after the traumatic event, is a rare subset and is often missed upon initial presentation. We discuss a case involving a 15-year-old female who presented with persistent nausea, vomiting, and epigastric pain and was subsequently diagnosed with TDH via chest x-ray, later confirmed by CT scan. Further investigation of the patient’s history revealed a motor vehicle accident one year prior in which the patient sustained an injury to the left chest. A chest x-ray at that time did not show signs of a diaphragmatic hernia. Surgical evaluation of the diaphragmatic defect further supported previous trauma as the mechanism of injury. Our patient’s presentation is particularly interesting considering the lack of TDH reported in the pediatric population, as well as the presenting complaints being primarily gastrointestinal rather than respiratory.