2019 Volume 39 Issue 7 Pages 1209-1212
We report a rare case of a 73-year-old woman with delayed traumatic incarcerated diaphragmatic hernia. The patient presented with severe epigastralgia. She had sustained traumatic injury of the right shoulder in a fall and undergone operation for repair of a rotator cuff tear 9 months earlier. Contrast-enhanced computed tomography revealed dilated intestinal loops, intestinal prolapse into the thorax, the closed loop sign and defect of contrast in the prolapsed intestine. Based on the findings, we diagnosed the patient as having incarcerated diaphragmatic hernia and undertook emergency surgery. Intraoperatively, some cracks were found in the right diaphragm, which seemed to be weakened. The diaphragm was injured and the ileum had prolapsed into the thorax through a defect in the diaphragm which was about 3 cm×3 cm in size. The prolapsed ileum was resected as it was found to be necrotic, and the defect in the diaphragm was sutured directly. After the operation, the patient made good progress.
