Lax Diaphragmatic Hernia Case Study
Abstract
Background: Spontaneous diaphragmatic hernia without any apparent history of trauma is a very rare condition.
Case: A 38year old female who was admitted to emergency department with abdominal pain, nausea and constipation for 5 days and was diagnosed with spontaneous diaphragmatic hernia. There was no significant past history of trauma. The patient was treated with laparotomy and the diaphragmatic defect was repaired primarily.
Conclusion: Spontaneous acquired diaphragmatic hernia due to lax and thinned out diaphragm is very rare condition and very difficult to diagnose unless a very high index of suspicion is kept in mind. Surgical repair is the definitive treatment.
Keywords: Spontaneous Diaphragmatic Hernia; Lax Diaphragm
Introduction
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Acute diaphragmatic hernia following trauma is rare, despite high prevalence of trauma. Up to 5% of trauma patients may suffer traumatic diaphragmatic injury [1,2]. Spontaneous acquired diaphragmatic hernia without any apparent history of trauma is even more rare presentation [3]. Early recognition of spontaneous acquired diaphragmatic hernia is of utmost importance because delay in the diagnosis may result in an increased morbidity and mortality. In this report, we present a patient who was admitted to emergency department with abdominal pain, nausea and constipation for 5days and was diagnosed with spontaneous non-traumatic diaphragmatic …show more content…
Coughing was the preceding event in 9 (32%) patients, physical exercise in 6 (21%), vaginal delivery in 4 (14%), vomiting in 2 (7%) and massage in 1 (4%); no history was available for single comatose patient. There were 5 (18%) patients in whom no effort preceded the hernia. Hamaoui et al. [9] reported a case of spontaneous diaphragmatic hernia in a 35-year-old male patient with Ehlers-Danlos syndrome, a genetic disorder that causes abnormalities in the synthesis and structure of collagen and can lead to multiple anatomical defects. Pehar et al. [10] reported a case of spontaneous diaphragmatic hernia related to local invasion by retroperitoneal liposarcoma. Servais et al. [11] suggested that symptomatic diaphragmatic eventration during pregnancy should be repaired during the third trimester once fetal organogenesis is complete in order to prevent further herniation from the enlarging uterus and the risk of hernia strangulation. Yang et al. [12] reported a spontaneous diaphragmatic hernia in a 29-year-old woman and suggested that spontaneous diaphragmatic hernia might be caused by a static sport activity, such as
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