Missed traumatic diaphragmatic hernia and literature review

Abstract

The diagnosis of traumatic diaphragmatic rupture owing to blunt or penetrating injuries may be missed in acute case presentations. Mortality in patients with acute blunt injuries is highest in those with associated organ damage. The diagnosis of diaphragmatic injuries may be missed because of delayed case presentation or delayed diagnosis. Diaphragmatic injuries should be suspected in all patients with blunt or penetrating injuries of the chest and abdomen. Special care must be taken during the insertion of intercostal drains to the chest in order to avoid iatrogenic injury to the stomach, bowel and other organs, particularly in cases when a missed diaphragmatic injury cannot be excluded. We share in this article our experiences with two cases of missed traumatic diaphragmatic injuries, one on the left and the other on the right side.