Delayed presentation of post traumatic diaphragmatic hernia

Abstract

Blunt traumatic diaphragmatic rupture is an uncommon but severe problem that is usually seen in polytraumatized patients including blunt abdomino-thoracic trauma due to road traffic accidents, fall from height and penetrating injuries. Regardless of the mechanism, diagnosis is often missed and high index of suspicion is vital. Late presentations are associated with increased morbidity. We report an interesting case of blunt traumatic diaphragmatic hernia in a 32-year-old man presenting 4 years after the initial abdomino-thoracic injury due to fall from height. He had herniation of the spleen and stomach. Through a left sub costal incision, the herniated organs were reduced and diaphragmatic defect closed with interrupted prolene suture.

Traumatic diaphragmatic injuries: a retrospective review of a 12-year experience at a tertiary trauma centre

“…They can also present as a state of haemodynamic instability due to bleeding from other concomitant injuries, or as a delayed manifestation of intestinal obstruction and respiratory involvement due to diaphragmatic hernia, months or even years after the actual trauma. (8,9) TDIs remain a diagnostic and therapeutic challenge for the emergency physician and trauma surgeon. They are often associated with thoracic and abdominal injuries that can be life-threatening and distract the attention of the clinician from the diaphragm.…”

Diaphragmatic hernia following a liver resection: A rare cause of bowel obstruction

“…The rate of a late presentation of an iatrogenic diaphragmatic hernia is disparate ranging from 5% to 62% of the cases [3], with delayed presentation occurring as late as many months or years after the supposedly harmful event [2,3,[11][12][13].…”

Hernia diafragmática complicada con rotura de víscera hueca dentro de la cavidad torácica

“…Aproximadamente el 75% de las roturas diafragmáticas son por trauma contuso y el 25% restante está dado por trauma penetrante. 0,8-1,6% de los pacientes con trauma contuso desarrollan una lesión diafragmática 3 . El trauma penetrante en la región tóraco-abdominal izquierda genera lesión diafragmática en un 70-90%.…”