[Diagnosis of non-hiatal diaphragmatic hernia using helical computed tomography]

The authors report the cases of two patients with non traumatic quiescent diaphragmatic hernias who presented with delayed but classical acute gastrointestinal complications. Their only predisposing factor was previous surgery of the left upper quadrant. The diagnosis, suspected on chest radiographs, was promptly performed by helical CT with multiplanar reconstructions (MPVR) and maximal intensity projections (MIP). The exact nature and relationship of the herniated organs, the precise site and size of the diaphragmatic defects were depicted with a noteworthy effectiveness allowing a prompt surgical treatment. Technical guidelines for helical CT of the diaphragm are purposed and the typical CT signs of diaphragmatic hernias are reviewed. The authors also emphasize the advantages of helical CT over other radiological procedures and confirm it as the actual standard for diagnosis of diaphragmatic diseases.