title: Management of delayed presentation of a right-side traumatic diaphragmatic rupture.
abstract: BACKGROUND
  Right-side diaphragmatic rupture is an unusual condition after blunt trauma. The diagnosis may be missed during the early period of trauma and may lead to progressive herniation of intraabdominal contents into the thorax. In this study, we aimed to evaluate the diagnosis and treatment options for the late diagnosis of cases of right-side traumatic diaphragmatic rupture.
  
  
  METHODS
  We evaluated the patients with diaphragmatic hernia who were admitted to the hospital during an 8-year period. Only patients with a right-side diaphragmatic hernia and a history of high-energy trauma were included in the study. Patients with left-side diaphragmatic hernia or those who were subjected to emergency operation due to diaphragmatic rupture were excluded from the study. Patient characteristics, clinical presentations, diagnostic tools, and treatment options were evaluated.
  
  
  RESULTS
  Eight patients (five men, three women) were enrolled in the study. The most common trauma type was a traffic accident, and the average interval between the trauma and diagnosis was 10 years. Thoracoabdominal computed tomography had high sensitivity and specificity for visualizing the diaphragmatic hernia. No predisposing factor was found to add laparotomy to thoracotomy. There was no postoperative mortality, and no late complications were observed at the assessments during the 45-month follow-up.
  
  
  CONCLUSIONS
  Clinical presentation of late diagnosed diaphragmatic hernia, which is encountered only rarely on the right side, requires diagnostic and therapeutic approaches different from those associated with acute diaphragmatic rupture. It should not be forgotten during the differential diagnosis in patients with a history of trauma.
authors.affiliation: Department of General Surgery, Trabzon Numune Training and Research Hospital, Maras Street, 61040, Trabzon, Turkey. draliguner@yahoo.com
authors.forename: Ali
authors.initials: A
authors.lastname: Guner
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Ozkan
authors.forename: Yildiray
authors.initials: Y
authors.lastname: Bekar
authors.forename: Can
authors.initials: C
authors.lastname: Kece
authors.forename: Umit
authors.initials: U
authors.lastname: Kaya
authors.forename: Erhan
authors.initials: E
authors.lastname: Reis
mesh_terms: D000328:Adult; D000368:Aged; D057210:Delayed Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006549:Hernia, Diaphragmatic, Traumatic / Q000175:diagnosis* / Q000601:surgery; D059685:Herniorrhaphy; D006801:Humans; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome