Delayed presentation of traumatic left-sided diaphragmatic avulsion - A case report

We describe the case of a 35-year-old man who had suffered a severe multi-t rauma with blunt thoracic injury, left scapula and humerus fractures 5 year s earlier. At the time of the trauma, a diaphragmatic lesion went unnoticed . Five years later, the patient had a 24-h history of increasingly severe a bdominal pain with repeated vomiting. Helical CT showed a portion of the le ft hemidiaphragm avulsed from its insertions on the ribs with large-bowel l oop obstruction herniated in the left hemithorax. The preoperative CT diagn osis was confirmed by surgery: reduction of the hernia and reinsertion of t he hemidiaphragm to the lumbocostal arch were performed.