Constipation. An uncommon etiology

An uncommon cause of chronic constipation is presented in a case report. The patient presented with chronic cough and constipation. Work-up revealed a loop of transverse colon herniated through a right diaphragmatic tear resulting from an old, blunt, abdominal injury. The diaphragmatic hernia was repaired through a right thoracotomy without complications. Diaphragmatic hernia should be ruled out in patients who present with chronic respiratory or vague abdominal symptoms, especially after a history of blunt abdominal trauma. Once the diagnosis is confirmed, expeditious surgical treatment should be undertaken to prevent the development of obstruction or strangulation and its grave consequences. Thoracotomy is the incision of choice, as it affords good exposure for lysis of adhesions, reduction of the hernia, and repair of the diaphragmatic defect.