A CASE OF TRAUMATIC HERNIA OF THE RIGHT DIAPHRAGM SUCCESSFULLY DIAGNOSED BY MAGNETIC RESONANCE IMAGING (MRI)

Abstract

A case of traumatic right diaphragmatic hernia which was successfully diagnosed by magnetic resonance imaging (MRI) is reported.
A 71-year-old man was seen at the hospital because of upper abdominal pain and vomiting after he got a bruice on the right aterior thoracic region when he fell down. A simple x-ray film of the chest revealed a right diaphragmatic elevation and gaseous distention. A diagnosis of right diaphragmatic hernia was made. In order to diagnose the contents and size of an openning of the hernia, chest MRI was performed. It revealed a clear picture that a portion of the colon from the ascending to transverse colon prolapsed from the hernia opening 2cm in diameter into the thoracic cavity. Emergency laparotomy revealed that the ascending colon, a part of the transverse colon and greater omentum prolapsed into the right thoracic cavity from a tendinous region anterior to the diaphragm; the hernia opening being 3×2cm in size.
MRI that is excellent in determination of prolapsed organs and visualization of the cephalocaudal continuation and is noninvasive is a very useful method for diagnosis of diaphragmatic hernia.