[Pleural exudate and intestinal obstruction. Late manifestation of traumatic diaphragmatic hernia]

The diagnosis of diaphragmatic rupture is most commonly made during surgical exploration following penetrating injuries, or in the presence of obvious herniation of viscera through the diaphragm. In the absence of acute herniation a diaphragmatic rupture frequently remains unrecognized and may cause herniation of intra-abdominal contents into the thorax after latency periods of up to several decades. Therefore diaphragmatic rupture is an important differential diagnosis in subjects with unclear abdominal conditions or unexplained pleural effusion in the presence of a history of previous thoracoabdominal trauma. A case is presented which highlights pitfalls and clinical findings.