Unrecognized Diaphragm Hernia

Abstract

Introduction: Post-traumatic diaphragmatic hernia is defined as the passage of abdominal viscera into the thorax through a post-traumatic diaphragmatic breach. They are rare and may be unrecognized in 10-30% of cases at initial management. Materials and Methods: A retrospective descriptive study including all the patients taken in charge for post-traumatic neglected diaphragmatic lesions over two years between December 2018 and January 2021 within the service of visceral emergencies of the universitary hospital center Ibn Rochd of Casablanca. Our work aims to define the epidemiological, clinical, and therapeutic characteristics of patients admitted for post-traumatic diaphragmatic lesions. Results: The average age of the patients was 30 years (range 18 to 43 years). All patients were male. They were due to a closed trauma in 11 patients (32%) and a penetrating trauma in 58%. The diagnosis was guided preoperatively by the different imaging techniques, in particular chest radiography and CT scan. Treatment was mainly by laparotomy and consisted of closure of the diaphragmatic breach by simple sutures. Conclusion: Post-traumatic diaphragmatic hernias can go unnoticed and can be life-threatening in case of associated lesions or complications.