Traumatic rupture of the diaphragm resulting in the sub-acute presentation of an incarcerated intra-thoracic transverse colon

Abstract

The traumatic rupture of the diaphragm after blunt or penetrating injuries is a well described but uncommon entity. Its presentation in the form of herniated abdominal contents into the thoracic cavity is generally obscure and the recognition of this condition is often challenging. Although many cases remain asymptomatic, significant morbidity and mortality ensues with patients who present with incarceration, strangulation and eventual visceral compromise. Definitive guidelines in the management of traumatic diaphragmatic injuries are still lacking. This report outlines a case of sub-acute presentation of a traumatic diaphragmatic rupture in an elderly female following a motor vehicle accident that required urgent surgical intervention. We reviewed the pertinent literature, with an emphasis on the operative approach and the type of repair of the traumatic diaphragmatic defect.

Laparoscopic repair of acute traumatic diaphragmatic hernia with mesh reinforcement: A case report

“…TDH is incorrectly diagnosed in up to 33% of cases during the immediate post-traumatic period. If left untreated, the onset of complications carries mortality rates between 25 and 80% in patients with strangulation of incarcerated viscera [10] , [11] . Diaphragmatic injuries do not close spontaneously, however in some cases omental interposition may seal a tear temporarily.…”