[Late posttraumatic diaphragmatic hernia. A clinical case report]

On the basis of the observation of one case of delayed presentation of traumatic diaphragmatic rupture of the left side with a late diaphragmatic hernia, the authors examine the evolution of the occurrence of this pathology during the last 20 years. The clinical signs and the modality of presentation of the lesions of delayed diagnosis appear absolutely non specific. Incorrect interpretation of the X-ray or only intermittent hernial symptoms are frequent reasons for incorrect diagnosis. Also the initially non recognition of the possible manifestation of the diaphragmatic hernia following blunt or penetrating injuries is usually because the practitioner has not sought it. The diaphragmatic domes must be systematically explored during the laparotomy or thoracotomy performed for thoraco-abdominal trauma. Surgical treatment of long-standing post-traumatic diaphragmatic hernia is the same as that applicable in the recent hernias.