Hajrah Hilal Ahmed, Saliha Afzal, Muhammad Jamaluddin.
Traumatic Diaphragmatic Hernia in a 40-Year-Old Lady after 34 Years of Trauma.
Ann Abbasi Shaheed Hosp Karachi Med Dent Coll Jan ;23(03):161-6.

The diaphragm is a sheath made of muscle and tendon that separates the thoracic cavity from the abdominal cavity. A diaphragmatic hernia is the protrusion of intra-abdominal contents through an abnormal opening in the diaphragm. Acquired diaphragmatic tears are rare and occur mainly due to direct penetrating injury to the diaphragm or, less commonly, secondary to blunt abdominal trauma, causing herniation of the abdominal contents into the thorax resulting in a condition known as post-traumatic diaphragmatic hernia. Signs and symptoms include orthopnea, dyspnea, diminished breath sounds on the side of the rupture and audible gut sounds in the chest. We report a case of a 40-year-old woman with a 34-year-old history of an unmanaged road traffic accident who presented with a complain of gradual in onset shortness of breath, which when approached surgically, revealed to be due to an absent left sided diaphragm. Upon diagnosis, successful primary hernia mesh repair was performed.

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