The incidence of traumatic diaphragmatic hernia has in recent years been rising with an increasing frequency of traffic injuries, labor and other accidents. We have recently encountered a case of traumatic diaphragmatic hernia which manifested itself as symptoms of a respiratory tract disorder 20 years after the accident. The patient was a 44-year-old male who suffered a contusion on the back 20 years ago when he fell from a height of about 3m.Around November 1988, he began to feel short of breath even when resting, and the symptom aggravated with time.On admission in March 1989 chest X-ray showed air bubbles in the left lower lung field. Radiologic studies of the upper alimentary tract and colon indicated that the corpus ventriculi and left colic flexure were elevated. On thoracolaparotomy, the left diaphragm was found to have a true traumatic diaphragmatic hernia with a hernial sac 13 cm in diameter. The hernia which was found to contain the stomach and colon was opened to reduce its contents into the abdominal cavity. The defect was closed nd reinforced by suturing the sac over the primary repair. The ptient ran a favorable postoperative course and was soon discharged with the dissolution of symptoms. A true traumatic diaphragmatic hernia, among other traumatic types, is a very rare disease. It is described in detail with reference to the literature.
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