Acute Intestinal Occlusion Revealing a Post-Traumatic Diaphragmatic Strangulated Hernia: A Case Report

Abstract

Introduction: The post-traumatic diaphragmatic hernia is a particular lesion in traumatology, which may go undetected in the acute phase of the trauma. Its detection is then often made following a digestive or respiratory complication. Acute intestinal occlusion is one of the complications revealing a strangulated diaphragmatic hernia. Case Presentation: 37-years-old patient with acute intestinal occlusion syndrome. His history included a closed thoracoabdominal trauma following a vehicular accident three years ago. The thoracoabdominal CT scan showed a distension of the haemic coves, transverse and ascending colon above a strangulation of the left colonic angle through a left diaphragmatic defect, with left pleural effusion of high abundance, responsible for a pulmonary collapse. The diagnosis retained is an intestinal occlusion on a strangulated post-traumatic left diaphragmatic hernia. Surgical exploration showed a distension of the hail and colic coves above a strangulated left diaphragmatic hernia with necrotic transverse colic content. The patient has benefited of a hernia reduction with transverse colic resection removing the necrotic colon and suture of the diaphragmatic breach. The evolution was favorable. Conclusion: The eventuality of a diaphragmatic hernia must always be suggested in case of violent thoraco abdominal trauma. Among the causes of intestinal occlusion, the strangulation of a diaphragmatic hernia should be considered, especially if there is a history of thoracoabdominal trauma.