Traumatic diaphragmatic hernia: a case report


  • Anand Kishore Department of Surgery, R. K. Life Line Hospital, Sirsa, Haryana, India
  • Ajeet Singh Department of Orthopaedics, R. K. Life Line Hospital, Sirsa, Haryana, India
  • Ashutosh Jain Department of Medicine, R. K. Life Line Hospital, Sirsa, Haryana, India



Computed tomography, Diagnostic laparoscopy, Hernia, Laparotomy, Traumatic diaphragmatic injury


Diaphragmatic injury is a rare entity and clinically difficult to be diagnosed as symptoms are often masked due to associated injury in a poly trauma case. There are no specific signs and symptoms for diagnosing diaphragmatic rupture. High degree of clinical suspicion is needed in all cases of thoraco-abdominal injury to diagnose a case of diaphragmatic rupture. Computed Tomography (CT) chest and abdomen is very useful in diagnosis. When in doubt a diagnostic laparoscopy should be undertaken to establish a diagnosis to reduce mortality and morbidity.


Kumar S, Pol M, Mishra B, Sagar S, Singhal M, Misra MC, et al. Traumatic diaphragmatic injury: a marker of serious injury challenging trauma surgeons. Indian J Surg. 2015;77:666-9.

Rosati C. Acute traumatic injury of the diaphragm. Chest Surg Clin N Am. 1998;8(2):371-9.

Shah R, Sabanathan S, Mearns AJ, Choudhury AK. Traumatic rupture of the diaphragm. Ann Thorac Surg. 1995;60(5):1444-9.

Mihos P, Potaris K, Gakidis J, Paraskevopoulos J, Varvatsoulis P, Gougoutas B et al. Traumatic rupture of the diaphragm: experience with 65 patients. Injury. 2003;34(3):169-72.

Rashid F, Chakrabarty MM, Singh R, Iftikhar SY. A review on delayed presentation of diaphragmatic rupture. World J Emerg Surg. 2009;4:1-7.

Fair KA, Gordon NT, Barbosa RR, Rowell SE, Watters JM, Schreiber MA. Traumatic diaphragmatic injury in the American College of Surgeons National Trauma Data Bank: a new examination of a rare diagnosis. Am J Surg. 2015;209:864-8.

Rossetti G, Brusciano L, Maffetone V, Napolitano V, Sciaudone G, DelGenio G et al. Giant right post-traumatic diaphragmatic hernia: laparoscopic repair without a mesh. Chir Ital. 2005;57:243-6.

Goh BK, Wong AS, Tay KH, Hoe MN. Delayed presentation of a patient with a ruptured diaphragm complicated by gastric incarceration and perforation after apparently minor blunt trauma. Canadian J Emerg Med. 2004;6:277-80.

Meyers BF, McCabe CJ. Traumatic diaphragmatic hernia. Occult marker of serious injury. Ann Surg. 1993;218:783-90.

Sangster G, Ventura VP, Carbo A, Gates T, Garayburu J, D'Agostino H. Diaphragmatic rupture: a frequently missed injury in blunt thoracoabdominal trauma patients. Emerg Radiol. 2007;13:225-30.

Eren S, Kantarci M, Okur A. Imaging of diaphragmatic rupture after trauma. Clin Radiol. 2006;61(6):467-77.

Thiam O, Konate I, Gueye ML, Seck M, Cisse M, Diop B, Dirie ES, Ka O, Thiam M, Dieng M, Dia A. Traumatic diaphragmatic injuries: epidemiological, diagnostic and therapeutic aspects. Springer Plus. 2016 Dec 1;5(1):1614.

Hanna WC, Ferri, Fata P, Razek T, Mulder DS. The current status of traumatic diaphragmatic injury: lessons learned from 105 patients over 13 years. Ann Thorac Surg. 2008;85:1044-8.

Dwari AK, Mandal A, Das SK, Sarkar S. Delayed presentation of traumatic diaphragmatic rupture with herniation of the left kidney and bowel loops. Case Rep Pulmonol. 2013;2013:4.

Ramdass M, Kamal S, Paice A, Andrews B. Traumatic diaphragmatic herniation presenting as delayed tension faecopneumothorax. Emerg Med J. 2006;23:e54.

DeBlasio R, Maione P, Avallone U, Rossi M, Pigna F, Napolitano C. Late posttraumatic diaphragmatic hernia. A clinical case report. Minerva Chir. 1994;49:481-7.

Reber PU, Schmied B, Seiler CA, Baer HU, Patel AG, Büchler MW. Missed diaphragmatic injuries and their long-term sequelae. J Trauma. 1998;44(1):183-8.

Killeen KL, Mirvis SE, Shanmuganathan K. Helical CT of diaphragmatic rupture caused by blunt trauma. AJR Am J Roentgenol. 1999;173(6):1611-6.

Warren O, Kinross J, Paraskeva P, Darzi A. Emergency laparoscopy–current best practice. World J Emerg Surg. 2006;1:24.






Case Reports