Abstract
Diaphragmatic injury is a rare occurrence, constituting less than 3 percent of all traumatic injuries. It typically arises from either blunt or penetrating trauma, presenting a notable challenge in clinical settings, with a 2:1 ratio of penetrating to blunt trauma(1). These injuries often elude immediate recognition or face delayed diagnosis, primarily due to their infrequency and the concurrent presence of more overt and severe traumas in patients. The delayed identification of diaphragmatic injuries can contribute to complications such as pulmonary issues, persistent abdominal pain, or acute bowel obstruction, thereby elevating the risk of morbidity and mortality. Here, we report a case of a 30-year-old man who exhibited a diaphragmatic hernia with large bowel obstruction which manifested following blunt abdominal and thoracic trauma that occurred three years prior to the current presentation.
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Corresponding Author
Venkatesh N