Abstract text (incl. references and figure legends)
Introduction: Traumatic diaphragmatic hernia is a condition in which the viscera located primarily intraabdominally migrate intrathoracically through a traumatic diaphragmatic opening. Despite being rare, it remains, a challenge because of a diagnoses delay and because in 90% of cases, is associated with multiple lesions with high morbidity and mortality. It is more common on the left side. An early diagnosis is essential because the best treatment is surgical intervention.
Material and methods: Case report09/2022
Results: 26 yo, male, healthy . Victim of a high kinetic car accident, being the driver. At admission, SpO2 94%, tachycardic, hypertensive, GS 15. In the ER, he underwent chest X-ray with elevation of the left hemicupula and Efast without complications. After stabilization, a thoracoabdominopelvic CT was performed, with an elevation of the left hemicupula, with ascending hollow viscera (traumatic hernia). An exploratory laparoscopy was performed, finding a left traumatic diaphragmatic hernia with migration of the stomach, spleen and splenic angle of the colon; a periduodenal and transverse colon hematoma. Partial reduction of intrathoracic hollow viscera was performed with subsequent conversion to laparotomy. Primary repair of the diaphragm was performed with suture and subsequent packing. The patient was left with a laparostomy, which was reviewed at 24h, with the evidence of a hepatic laceration that was sutured and a decrease in the hematoma. There was no evidence of other injuries, with subsequent closure. Then the patient was discharged, fully recovered, without complications.
Conclusion: Traumatic diaphragmatic hernia without injury to other hollow viscera is a rare condition. In this case, the early diagnosis allowed an early surgical intervention that resulted in a good outcome for the patient.
References:Yeo C. et al, Shackelford"s surgery of the alimentary tract, 8th edition; Zinner M et al, Maingot"s Abdominal Operations, 13th edition
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