title: Twenty-seven year old man presenting with a strangulated diaphragmatic hernia eight years after the initial injury.
abstract: A 27-year-old man presented with a 5 day history of abdominal pain and distension, with associated constipation and vomiting. He had presented 8 years earlier following a traumatic injury to the left side of the chest, and no diaphragmatic injury was reported at that time. On this admission, a computed tomography scan showed herniation of the splenic flexure of the colon into the left hemithorax. Subsequently, he had an emergency laparotomy for resection, with formation of a loop ileostomy. The various imaging techniques all have advantages and disadvantages when diagnosing a traumatic diaphragmatic hernia. It is the clinician's role to maintain a high index of suspicion when a patient initially presents with trauma where a traumatic diaphragmatic hernia may be a possibility.
authors.affiliation: Rochdale Infirmary (Pennine Acute Hospitals Trust), Whitehall Street, Rochdale OL12 0NB, UK.
authors.forename: Reena
authors.initials: R
authors.lastname: Morjaria
authors.forename: Hashim
authors.initials: H
authors.lastname: Al-Gailani
authors.forename: Sikander
authors.initials: S
authors.lastname: Afzal
authors.forename: Sohail
authors.initials: S
authors.lastname: Sabir
authors.forename: Saad
authors.initials: S
authors.lastname: Salman