[Traumatic diaphragmatic hernia of late onset]

The diaphragmatic hernia usually appears in neonatal period. The late onset, due to diafragmatic tear after blunt trauma, is exceptional. We report the case of a boy aged 13, who was studied for epigastric pain since two months. Contrast gastrointestinal study showed bowel loops in left hemithorax. The patient had a blunt abdominal trauma due to a fallen from a horse, when he was 6 year old. It was performed a thoracotomy with reinsertion of intestinal structures into the abdomen and closure of the anterolateral tear of left hemidiaphragm. Postoperative progress was without event and the boy was discharged home well. We emphasize the lack of symptoms during seven years after trauma and we point out that diaphragm rupture may occur. Symptoms could be no specific, only light respiratory or digestive alterations.