title: Minimally invasive repair of traumatic right-sided diaphragmatic hernia with delayed diagnosis.
abstract: BACKGROUND
  Traumatic diaphragmatic hernias are a diagnostic and therapeutic challenge due to variable presentations. Early repair is important because of risks of incarceration and strangulation of abdominal contents along with respiratory and cardiovascular compromise. Minimally invasive techniques have been useful for diagnosis and treatment of diaphragmatic hernias in both blunt and penetrating trauma.
  
  
  METHODS
  We present the case of a 54-year-old victim of a motor vehicle crash who presented with a delayed diagnosis of a right-sided traumatic diaphragmatic hernia. By using a 4-port technique and intracorporeal suturing, the hernia was repaired. This case highlights the difficulties associated with diagnosing diaphragmatic hernias and the role of minimally invasive techniques to repair them.
  
  
  CONCLUSIONS
  Minimally invasive surgical techniques are being increasingly used to both diagnose and repair traumatic diaphragmatic injuries with excellent results.
authors.affiliation: Department of General Surgery, New York Medical College, Valhalla, NY 10595, USA.
authors.forename: Maria R
authors.initials: MR
authors.lastname: Ver
authors.forename: Aleksandr
authors.initials: A
authors.lastname: Rakhlin
authors.forename: Francis
authors.initials: F
authors.lastname: Baccay
authors.forename: Bindu
authors.initials: B
authors.lastname: Kaul
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Kaul
mesh_terms: D000063:Accidents, Traffic; D005260:Female; D006549:Hernia, Diaphragmatic, Traumatic / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009104:Multiple Trauma; D001261:Pulmonary Atelectasis / Q000000981:diagnostic imaging; D012131:Respiratory Insufficiency / Q000209:etiology; D013610:Tachycardia / Q000209:etiology; D013995:Time; D014057:Tomography, X-Ray Computed