Undiagnosed Post-traumatic Diaphragmatic Hernia Presenting with Colonic Obstruction: A Case Report and Literature Review

Abstract

Post-traumatic diaphragmatic hernia, also referred to as diaphragmatic rupture, is a rare condition that is often missed during the initial evaluation following trauma. Delayed diagnosis is associated with increased morbidity and mortality. Post-traumatic diaphragmatic hernia is an insidious condition, often characterised by a latent and atypical clinical presentation. It typically results from herniation of abdominal viscera through a diaphragmatic defect, most commonly caused by penetrating trauma. The case study aims to undiagnosed post-traumatic diaphragmatic hernia revealed by colonic obstruction. We report the case of a patient with a history of neglected abdominal trauma following a fall, who later presented with signs of intestinal obstruction. An emergency laparotomy revealed herniation and incarceration of the colon within the thoracic cavity through a diaphragmatic defect. The treatment of diaphragmatic hernia involves surgical reduction of the herniated abdominal contents into the peritoneal cavity and closure of the diaphragmatic defect, either by direct suturing or the use of a prosthetic mesh. This case highlights the importance of thorough radiologic evaluation following high-energy abdominal trauma to detect potential diaphragmatic injuries early and prevent delayed complications.