Left traumatic diaphragmatic hernia. Case report

Abstract

Introduction: Traumatic diaphragmatic hernia in the adult is unusual, however, its diagnosis tends to be late; in the presence of severe complications.
Objective: To present the clinical and surgical evolution of a patient with traumatic left diaphragmatic hernia.
Clinical case: It is described the case of a male patient, black skin color, 47 years old, from a rural area, with an individual pathological history of arterial hypertension for which he is under regular treatment. He came to the emergency department after having been involved in a traffic accident 12 days earlier, where he was hit by a car. He reported moderate pain in the left hemithorax, associated with respiratory difficulty, which was exacerbated at night and in the lateral decubitus position, so he had to sleep sitting up. In addition, he complained of abdominal distension and gastric fullness. Imaging tests were performed: anteroposterior chest X-ray and computed tomography, diagnosing a left traumatic diaphragmatic hernia. Surgical treatment was decided, thoracotomy and laparotomy were performed, where the previous diagnosis was confirmed, and splenectomy and phrenorrhaphy were performed, he evolved satisfactorily in the Intensive Care Unit, then he was transferred to the ward where he was discharged from the hospital due to his favorable evolution.
Conclusions: Traumatic diaphragmatic hernia is associated with life-threatening injuries. We present the case of a patient with a diagnosis of left traumatic diaphragmatic hernia, who underwent surgical treatment of splenectomy and frenorrhaphy, evolving favorably, and was discharged from the hospital and followed up by an outpatient clinic.
DeCS: HERNIA, DIAPHRAGMATIC; HERNIA, DIAPHRAGMATIC, TRAUMATIC/ diagnostic IMAGING; DIAPHRAGMATIC, TRAUMATIC/surgery; SPLENECTOMY; CLINICAL EVOLUTION.