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TRAUMATIC DIAPHRAGMATIC HERNIA WITH INTESTINAL OBSTRUCTION IN A CHILD: A CASE REPORT

J M Njem1, B T Ugwu1, E D Dung1

  • 1Cardiothoracic Surgery Unit, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.

Journal of the West African College of Surgeons
|December 5, 2019
PubMed

Insights

Pediatric diaphragmatic hernias from trauma are rare and often missed. A 6-year-old boy experienced delayed intestinal obstruction four years after a traumatic diaphragmatic injury, highlighting atypical presentations in children.

Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Gastrointestinal Surgery

Background:

  • Diaphragmatic ruptures in children, though uncommon, are frequently missed or delayed diagnoses due to their rarity and association with more severe injuries.
  • Traumatic diaphragmatic hernias can present years after the initial injury, complicating diagnosis and management in pediatric patients.

Observation:

  • A 6-year-old boy presented with acute intestinal obstruction.
  • The obstruction was attributed to a traumatic diaphragmatic hernia that occurred four years prior to presentation.
  • Classical signs of intestinal obstruction were notably absent in this case.

Findings:

  • Delayed presentation of traumatic diaphragmatic hernia leading to intestinal obstruction is possible in pediatric trauma.
  • Clinical presentation in pediatric patients with diaphragmatic injuries may not reflect the injury's severity or typical symptoms.
  • Atypical presentations of intestinal obstruction can occur in children with diaphragmatic hernias.

Implications:

  • Highlights the importance of considering delayed complications of diaphragmatic trauma in children, even years later.
  • Emphasizes that pediatric patients may not exhibit classic signs of intestinal obstruction, necessitating a high index of suspicion.
  • Underscores the need for thorough evaluation and long-term follow-up for pediatric trauma patients with suspected diaphragmatic injuries.

Keywords:
Diaphragmatic ruptureHerniated stomachIntestinal obstructionSurgical repair

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