Presentation
History of chest trauma. Referred for positional left chest pain.
Patient Data
Parts of bowel loops, including splenic flexure of the colon, are herniated into the thorax through a defect in the lateral aspect of the left hemidiaphragm, causing mild left lung base collapse.
The anterior arch of the left 5th and 6th ribs shows evidence of prior fracture.
A small metallic foreign body is also noted posterior to the cardiac shadow.
There are mild peribronchial opacities in the central segments of both lungs.
Case Discussion
Acquired diaphragmatic hernia through an old post-traumatic diaphragmatic defect in a 60-year-old man with positional chest pain.
Traumatic diaphragmatic rupture through either penetrating injury (65%) or blunt trauma (35%) is one of the most common causes of diaphragmatic hernia in adult patients. Depending on the location and size of the defect, retroperitoneal or intra-abdominal organs and tissues can prolapse into the thoracic cavity due to negative intrathoracic pressure.
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