Traumatic diaphragmatic hernia presenting as acute surgical emergency: a case report with review of literature

With increasing number of road traffic accidents involving either blunt or penetrating injury to abdomen, a high degree of suspicion for traumatic diaphragmatic tear should always be kept in mind. Patients with acute tear in diaphragm along with herniation of abdominal contents often present with strangulated bowel and respiratory distress thereby increasing both morbidity and mortality. We report such a case of road traffic accident with acute diaphragmatic tear in left hemi diaphragm with herniation and strangulation of transverse colon resulting in gangrene and perforation causing faecothorax, acute respiratory distress and septicemia who was managed surgically with an immediate exploratory laparotomy with closure of diaphragmatic defect and left thoracic drain and resection of gangrenous bowel and colo-colic anastomosis with proximal divergent ileostomy. The patient was discharged satisfactorily after ileostomy closure.