Professional paper

Delayed presentation of a traumatic diaphragmatic hernia

Chi-Tun Tang ; Department of Neurological Surgery, Tri-Service General Hospital, #325, Cheng-Kung Road, Section 2, Taipei 114, Taiwan, Republic of China
Ming-Ying Liu ; Department of Emergency Medicine, Department of Neurological Surgery, Tri-Service General Hospital, #325, Cheng-Kung Road, Section 2, Taipei 114, Taiwan, Republic of China. Department of Emergency Medicine, Tri-Service General Hospital, National Defense M
Chi-Tun Tang ; Department of Neurological Surgery, Tri-Service General Hospital, #325, Cheng-Kung Road, Section 2, Taipei 114, Taiwan, Republic of China

Abstract

Delayed presentation of a traumatic diaphragmatic hernia is an infrequent condition with a high mortality and morbidity rate. This case describes a 26-year-old man presenting with a 2-day history of cramping abdominal pain, dyspnea, nausea, and vomiting. The patient reported a penetrating thoracic injury one year prior to the development of clinical signs. Computed tomography revealed the presence of empyema or parapneumonic effusion of the left hemithorax. Based on the clinical history and physical findings, a diaphragmatic hernia was considered and an emergency laparotomy with segmental resection of strangulated jejunum and reduction of remaining bowel was performed. A 1.5 cm tendinous defect was identified and repaired. The patient recovered and was discharged uneventfully.
Conclusion: the early recognition of a delayed diaphragmatic hernia contributed to the uneventful recovery of this critically ill patient.

Keywords

traumatic diaphragmatic hernia; penetrating thoracic injury; helical computed tomography; emergent laparotomy; tendon defect

Hrčak ID:

67510

URI

https://hrcak.srce.hr/67510

Publication date:

1.4.2011.

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