Delayed diagnosis of traumatic diaphragmatic hernia may cause colonic perforation: a case report.

Cases Journal
Orhan Veli OzkanIlhan Paltaci

Abstract

Early diagnosis of diaphragmatic rupture after traumas may be difficult, and delayed diagnosis may result in increased morbidity and mortality. This paper describes the case of a 32-year-old man who experienced a traffic accident and had diagnosis of traumatic diaphragmatic hernia nearly four months later. The patient was referred to our emergency room suffering from ileus symptoms. Physical examination demonstrated an apparent abdominal distention, tenderness at the upper abdominal quadrants, rebound, and defense. Thoraco-abdominal X-rays and computerized tomography imaging demonstrated intestinal segments with air-fluid levels in thorax. Laparotomy was performed after a preoperative diagnosis of a strangulated-diaphragmatic hernia. At abdominal exploration, it was found that transverse colon and omentum entered into thorax through diaphragmatic defect located at the left diaphragm. Herniating colon segment was complicated with ischemic necrosis and perforation. In conclusion, colon necrosis and perforation may develop when early diagnosis of diaphragmatic ruptures are missed.

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Citations

Sep 6, 2015·Diagnostic and Interventional Imaging·L Saint-ValP Béroud
Jul 6, 2014·Annals of the Royal College of Surgeons of England·J WigleyA King
Nov 5, 2020·Journal of the American College of Emergency Physicians Open·Benjamin J GencoChristopher N Belcher
Feb 10, 2021·European Journal of Medical Research·Morris BeshayJan Schulte Am Esch

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