Undiagnosed Post-traumatic Diaphragmatic Hernia Presenting with Colonic Obstruction: A Case Report and Literature Review
Kamal Khadija
Department of General Surgery, Ibn Rochd University Hospital of Casablanca, Hassan II University of Casablanca, Morocco.
Nassima Fakhiri
Department of General Surgery, Ibn Rochd University Hospital of Casablanca, Hassan II University of Casablanca, Morocco.
Ilias El Azhari *
Department of General Surgery, Ibn Rochd University Hospital of Casablanca, Hassan II University of Casablanca, Morocco.
Fadoua Zalarh
Department of General Surgery, Ibn Rochd University Hospital of Casablanca, Hassan II University of Casablanca, Morocco.
Abdelhak Ettaoussi
Department of General Surgery, Ibn Rochd University Hospital of Casablanca, Hassan II University of Casablanca, Morocco.
Abdessamad Majd
Department of General Surgery, Ibn Rochd University Hospital of Casablanca, Hassan II University of Casablanca, Morocco.
Mounir Bouali
Department of General Surgery, Ibn Rochd University Hospital of Casablanca, Hassan II University of Casablanca, Morocco.
Abdelilah El Bakouri
Department of General Surgery, Ibn Rochd University Hospital of Casablanca, Hassan II University of Casablanca, Morocco.
Khalid El Hattabi
Department of General Surgery, Ibn Rochd University Hospital of Casablanca, Hassan II University of Casablanca, Morocco.
*Author to whom correspondence should be addressed.
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.
Keywords: Diaphragmatic hernia, case report, colonic obstruction, diaphragm muscle