A traumatic diaphragmatic hernia is a rare combined problem involving injuries to the thorax and abdomen that may not be diagnosed at the time of injury. Surgical management is mandatory when the patient displays any signs of bowel strangulation due to the herniation because a herniated bowel has a very high risk of necrosis or perforation. Four patients were diagnosed with delayed traumatic diaphragmatic hernia 14 to 96 months after injury. In two patients, the diaphragmatic injury was missed at the time of injury. Reduction and diaphragm repair surgery were performed. One diaphragm was repaired with artificial mesh. Traumatic diaphragmatic injury is caused by a blunt or penetrating injury to the abdomen or thorax. After migration of the intra-abdominal contents into the chest, a narrow herniation defect can disturb the bowel circulation and passage of bowel contents. Early detection and reduction, and repair surgery are mandatory for patients with a delayed presentation of complicated traumatic diaphragmatic hernia. Any patient with injury around the thorax or upper abdomen should be examined carefully considering the possibility of diaphragmatic hernia. Even if diaphragmatic injuries are not found in the initial evaluation, a radiology examination in a short period of time can correct the missed diagnosis of traumatic diaphragmatic hernia.
Abdomen ; Delayed Diagnosis ; Diagnosis ; Diaphragm ; Hernia, Diaphragmatic ; Hernia, Diaphragmatic, Traumatic ; Humans ; Necrosis ; Thorax

Diaphragmatic hernia was found in a patient who had undergone transhiatal esophagectomy for early esophageal cancer. Chest X-ray was not helpful, but abdominal or chest computed tomography was useful for accurate diagnosis. Primary repair through thoracotomy was performed and was found to be feasible and effective. However, long-term follow-up is required because hernia recurrence is common.
Diagnosis ; Esophageal Neoplasms* ; Esophagectomy* ; Follow-Up Studies ; Hernia ; Hernia, Diaphragmatic* ; Humans ; Recurrence ; Thoracotomy ; Thorax

Echinococcosis ; diagnosis ; surgery ; Female ; Hernia, Diaphragmatic ; diagnosis ; surgery ; Humans ; Middle Aged ; Surgical Mesh

Posttraumatic diaphragmatic hernia is a rare cause of large bowel obstruction, and can present weeks or years after the initial trauma. Herein, we report the case of a 28-year-old man who presented with signs and symptoms of bowel obstruction nine months after he had a stab wound to his left chest. Chest radiography showed multiple air‑fluid levels in the right upper quadrant, an air-fluid level in the left thoracic cavity and significant free air under the diaphragm. Exploratory laparotomy revealed a contaminated abdomen with perforations in the caecum and proximal transverse colon, and a 4 cm × 4 cm defect in the left posterolateral (septal) aspect of the diaphragm, which was closed with a nonabsorbable suture. Posttraumatic diaphragmatic hernias should be part of the differential diagnosis for patients with bowel obstruction, especially if there is a history of trauma. Radiography is useful in facilitating a quick diagnosis.
Adult ; Colon, Transverse ; Colonic Diseases ; diagnosis ; etiology ; Diagnosis, Differential ; Hernia, Diaphragmatic, Traumatic ; complications ; diagnosis ; Humans ; Intestinal Obstruction ; diagnosis ; etiology ; Male ; Tomography, X-Ray Computed

Adult ; Female ; Fractures, Bone ; complications ; Hernia, Diaphragmatic, Traumatic ; diagnosis ; etiology ; Humans ; Pelvic Bones ; injuries

Hiatal hernia and Morgagni hernia are sorts of diaphragmatic hernias that are rarely detected on transthoracic echocardiography. Although echocardiographic findings have an important role for differential diagnosis of cardiac masses, we often might overlook diaphragmatic hernia. We report three cases of diaphragmatic hernias having specific features. The first case is huge hiatal hernia that encroaches left atrium with internal swirling flow on transthoracic echocardiography. The second case is a hiatal hernia that encroaches on both atria, incidentally detected on preoperative echocardiography. The third case is Morgagni hernia which encroaches on the right atrium only. So, we need to consider possibility of diaphragmatic hernia when we find a cardiac mass with specific echocardiographic features.
Diagnosis, Differential ; Echocardiography ; Heart Atria ; Hernia ; Hernia, Diaphragmatic* ; Hernia, Hiatal

Most of the congenital diaphragmatic hernia (CDH) cases are diagnosed at prenatal period or immediately after birth with severe respiratory symptom. The classic triad, which is respiratory distress, apparent dextrocardia and a scaphoid abdomen, is usually seen in this period. Several case reports have described older infants and children with a wide spectrum of symptoms of CDH, whereas extremely few cases were reported in neonatal period except classic triad such as straungulation of the bowel. These atypical manifestations can lead physician to delayed diagnosis. We report two cases of CDH newborns. First case was diagnosed with pneumoperitoneum following tension pneumothorax, transient diaphragm eventration on 5 days after birth. The other case was diagnosed with failure to thrive and mediastinal mass on 30 days after birth. These cases suggest physicians to consider CDH in late newborn period with pneumoperitoneum following tension pneumothorax, transient diaphragm eventration, failure to thrive, and mediastinal mass.
Abdomen ; Child ; Delayed Diagnosis ; Dextrocardia ; Diaphragmatic Eventration ; Failure to Thrive ; Hernia, Diaphragmatic* ; Humans ; Infant ; Infant, Newborn* ; Parturition ; Pneumoperitoneum ; Pneumothorax

Congenital thoracic ectopic kidney is a very rare developmental disorder and the rarest type of ectopic kidney. This condition is usually asymptomatic and detected incidentally on routine chest radiography. Most cases of thoracic ectopic kidney develop in adulthood and during the neonatal period, and congenital thoracic ectopic kidney rarely develops in children. Most patients are asymptomatic, and the treatment depends on the diagnosis. Herein, we report a rare case of ectopic thoracic kidney associated with a diaphragmatic hernia in a 15-month-old male infant, who presented with periodic severe irritability. The thoracic ectopic kidney was detected as a mass in the right base of the chest on routine chest radiography.
Child ; Diagnosis ; Hernia, Diaphragmatic* ; Humans ; Infant* ; Kidney* ; Male ; Radiography ; Thorax

Hernia, Diaphragmatic ; diagnosis ; surgery ; Humans ; Male ; Middle Aged

Because of its safety and treatment effectiveness, the popularity of radiofrequency ablation (RFA) for the treatment of hepatocellular carcinoma (HCC) has gradually increased. However, some serious complications of RFA such as hepatic infarction, bowel perforation, and tumor seeding have been reported. Recently, we experienced a case of diaphragmatic hernia after RFA for HCC. A 61-year-old man with alcoholic cirrhosis was diagnosed with a 1.0 cm sized HCC in segment (S) 5 and a 1.3 cm sized HCC in S 8 of the liver. He was treated by transarterial chemoembolization and RFA. After RFA, an abdominal CT revealed a diaphragmatic defect with herniating mesentery. Twenty-two months after the RFA, the chest CT showed the diaphragmatic defect with herniating colon and mesentery. Because he had no symptoms, and surgical repair for the diaphragmatic hernia would be a high risk operation for him, we decided to treat the patient conservatively. For its great rarity, we report this case with a review of the literature.
Carcinoma, Hepatocellular/*diagnosis/*radiotherapy/therapy ; Catheter Ablation/*adverse effects ; Chemoembolization, Therapeutic ; Hernia, Diaphragmatic/*etiology/surgery ; Humans ; Liver Cirrhosis, Alcoholic/complications/*diagnosis ; Liver Neoplasms/*diagnosis/*radiotherapy/therapy ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Tomography, X-Ray Computed