Laparoscopic treatment of bowel obstruction as a late presentation of traumatic diaphagmatic hernia: case report

Design of the study: Case report. Objectives: To present, through a case report, a post-traumatic diaphragmatic hernia with late diagnosis and reinforce the importance of systematic research of diaphragmatic injury in thoracoabdominal trauma. Relevance: the incidence of post traumatic diaphragmatic hernia in polytrauma is 8% and presents little morbidity if diagnosed at the time of trauma. However, the morbidity increases significantly if it is diagnosed late. Surgical repair is the appropriate treatment and laparoscopic approach presents itself as a minimally invasive alternative. Case report: Patient with late left diaphragmatic lesion diagnosed four years after penetrating trauma. As clinical signs presented strong left hypochondrial pain, and stop elimination of gases and faeces. He was submitted to videolaparoscopy, with a view of diaphragmatic hernia, reduction of herniated organs, suture of the diaphragmatic defect and thoracic drainage. Had an uneventful recovery and was discharged on the fourth postoperative day. Comments: post traumatic diaphragmatic hernia should be investigated in all patients with lesions in thoracoabdominal region. As can be asymptomatic, it is necessary systematic research to diagnosis, avoiding late complications associated with high morbidity and mortality rates