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[Two delayed cases of traumatic diaphragmatic hernia].

R Ishibe1, S Ogata, M Uto

  • 1Department of Surgery, Sendai Citizen Hospital, Sendai, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 24, 2004
PubMed
Summary

Delayed diagnosis of blunt traumatic diaphragmatic hernia is common, often overlooked. Suspect diaphragmatic rupture in all thoracoabdominal blunt injuries to ensure timely intervention.

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Area of Science:

  • Trauma Surgery
  • Thoracic Surgery
  • Abdominal Surgery

Background:

  • Blunt traumatic diaphragmatic hernia (TDH) is a rare but serious injury.
  • Delayed diagnosis of TDH can lead to significant morbidity and mortality.
  • This report highlights two cases of TDH with delayed diagnosis.

Observation:

  • Case 1: Left-sided TDH with delayed diagnosis of 1 month, presenting with severe dyspnea and gastric herniation into the thoracic cavity.
  • Case 2: Right-sided TDH discovered incidentally during laparoscopic cholecystectomy, with liver herniation into the thoracic cavity, diagnosed 6 years after initial trauma.
  • Both cases illustrate the potential for TDH to be overlooked, even with significant thoracoabdominal trauma.

Findings:

  • Delayed diagnosis of traumatic diaphragmatic hernia is a significant clinical challenge.

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  • Symptoms such as dyspnea can indicate diaphragmatic rupture, necessitating urgent surgical evaluation.
  • Incidental findings during unrelated surgeries can reveal long-standing, undiagnosed TDH.

    • Implications:

    • Increased clinical suspicion for diaphragmatic rupture is crucial in patients with thoracoabdominal blunt injuries.
    • Early diagnosis and surgical repair of TDH are essential to prevent complications.
    • Awareness of TDH presentation and diagnostic challenges can improve patient outcomes.