Delayed herniation of intra-abdominal contents after blunt right-sided diaphragm rupture

Woman with nausea and abdominal pain after a motor vehicle collision

“…3 Sensitivities of X-ray alone for diaphragm injury without herniation is 25%-50%. 4 With the use of newer generation CT scanners, the diagnostic sensitivity for detecting diaphragmatic injuries at the time of injury is 71%-90%. 5 Despite improved sensitivities with CTs, in the setting of recent blunt trauma and new or worsening abdominal pain, a low threshold should be maintained to initiate workup for delayed diaphragmatic injury because of its associated morbidity and mortality of 40%-60% if missed.…”

“…The timeframe from injury to presentation ranges from days to years after the inciting event, with the longest reported delay being 50 years 3 . Sensitivities of X‐ray alone for diaphragm injury without herniation is 25%–50% 4 . With the use of newer generation CT scanners, the diagnostic sensitivity for detecting diaphragmatic injuries at the time of injury is 71%–90% 5 .…”

Delayed Traumatic Diaphragm Hernia after Thoracolumbar Fracture in a Patient with Ankylosing Spondylitis

“…However, the more acceptable explanation for the delayed detection of diaphragmatic defects is that the injury usually only manifests when the herniation occurs 12) . Patients with an undiagnosed rupture of the diaphragm can develop symptoms after a delay of weeks, months, or even years 6) . There are no gold diagnostic methods with a high sensitivity or specificity.…”