Shahid Hussain Soomro, Aklima Asad Abro, Vaqare Sahar Shah, Hafeezullah Abro.
Traumatic diaphragmatic hernia presenting with intestinal obstruction: case report.
Rawal Med J Jan ;36(3):244-5.

Diaphragmatic hernia is a life threatening condition. Diaphragmatic injures are quite uncommon and often results from either blunt or penetrating trauma. There is often delay between injury & the diagnosis. We are presenting a case of 35 years old man who experienced a trauma after fall from camel, presented one year later after injury and had diagnosed a case of traumatic diaphragmatic hernia nearly 1 year later. Clinical examination revealed intestinal obstruction. X-ray abdomen & computed tomography (CT) revealed gas shadow with air fluid level in left hemi thorax. Laparotomy was performed & it was found that stomach, transverse colon & greater omemtum where herniating into thoracic cavity, through defect on the left sided. Due to lot of adhesion, left thoracotomy was done as well. Herniating colon was gangrenous & perforated. Gangrenous portion excised colostomy made & diaphragm repaired with non absorble suture material. Post operatively gut start functioning but patient developed wound infection. Lung did not expand so patient referred to thoracic department for further management.

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