Traumatic diaphragmatic hernia: an unusual presentation

Abstract

INTRODUCTION THE diagnosis of traumatic diaphragmatic hernia is often difficult, relying on a high index of suspicion and is frequently delayed, overlooked or missed (Noon et al., 1966). Delayed operative repair is associated with an increased morbidity and mortality (Hegarty et al., 1978). The majority of traumatic diaphragmatic hernias occur on the left (Noon et al., 1966; Ball et al., 1982). When a traumatic diaphragmatic hernia occurs on the right, it is usually the liver which herniates. Traumatic herniation of bowel on the right without liver herniation is unusual and, to our knowledge, has not been described in the literature. In this report we describe a case of right diaphragmatic bowel herniation in which the diagnosis was made only after a barium contrast study had been carried out. Awareness of this condition is important in order to avoid the potentially fatal complications.