Delayed intestinal obstruction due to posttraumatic diaphragmatic hernia

Cir Cir. 2012 Jan-Feb;80(1):72-5.

Abstract

Background: Diaphragmatic rupture can be missed during trauma diagnosis. Different pressures between the thorax and the abdomen allow the abdominal viscera to herniate into the chest cavity. Cardiorespiratory and abdominal symptoms may appear later due to passive compression and incarceration, respectively.

Clinical case: We report the case of a 52-year-old female with abdominal pain and vomiting. Chest x-ray demonstrated an elevation of the right hemidiaphragm, and computed tomography showed herniation of small bowel and colon into the chest cavity with dilated small bowel due to a diaphragmatic hernia.

Conclusions: History of traumatic events should be considered with high suspicion in the diagnostic process to avoid delayed diagnosis of this condition. The nonspecific symptoms of this condition often lead the patient to consult different specialists. A multidisciplinary approach is required and aimed at preventing an unnecessary increase of morbidity and mortality.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Accidents, Traffic
  • Colon
  • Female
  • Gastroesophageal Reflux / etiology
  • Hernia, Diaphragmatic, Traumatic / complications*
  • Hernia, Diaphragmatic, Traumatic / diagnostic imaging
  • Hernia, Diaphragmatic, Traumatic / surgery
  • Herniorrhaphy
  • Humans
  • Ileal Diseases / diagnostic imaging
  • Ileal Diseases / etiology*
  • Ileal Diseases / surgery
  • Intestinal Obstruction / diagnostic imaging
  • Intestinal Obstruction / etiology*
  • Intestinal Obstruction / surgery
  • Intestine, Small
  • Middle Aged
  • Pressure
  • Pulmonary Atelectasis / etiology
  • Pyloric Antrum
  • Radiography
  • Time Factors