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RMJ. 2011; 36(3): 244-245


Traumatic diaphragmatic hernia presenting with intestinal obstruction: case report

Shahid Hussain Soomro, Aklima Asad Abro, Vaqar-e-Sahar Shah, Hafeezullah Abro.

Abstract
Diaphragmatic hernia is a life threatening condition. Diaphragmatic injures are quite uncommon and often results from either blunt or penetrating trauma. There is often delay between injury & the diagnosis. We are presenting a case of 35 years old man who experienced a trauma after fall from camel, presented one year later after injury and had diagnosed a case of traumatic diaphragmatic hernia nearly 1 year later.
Clinical examination revealed intestinal obstruction. X-ray abdomen & computed tomography (CT) revealed gas shadow with air fluid level in left hemi thorax.
Laparotomy was performed & it was found that stomach, transverse colon & greater omemtum where herniating into thoracic cavity, through defect on the left sided. Due to lot of adhesion, left thoracotomy was done as well. Herniating colon was gangrenous & perforated.
Gangrenous portion excised colostomy made & diaphragm repaired with non absorble suture material. Post operatively gut start functioning but patient developed wound infection. Lung did not expand so patient referred to thoracic department for further management.

Key words: Blunt trauma, Diaphragmatic hernia, intestinal obstruction.



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