title: Delayed intestinal obstruction due to posttraumatic diaphragmatic hernia.
abstract: BACKGROUND
  Diaphragmatic rupture can be missed during trauma diagnosis. Different pressures between the thorax and the abdomen allow the abdominal viscera to herniate into the chest cavity. Cardiorespiratory and abdominal symptoms may appear later due to passive compression and incarceration, respectively.
  
  
  METHODS
  We report the case of a 52-year-old female with abdominal pain and vomiting. Chest x-ray demonstrated an elevation of the right hemidiaphragm, and computed tomography showed herniation of small bowel and colon into the chest cavity with dilated small bowel due to a diaphragmatic hernia.
  
  
  CONCLUSIONS
  History of traumatic events should be considered with high suspicion in the diagnostic process to avoid delayed diagnosis of this condition. The nonspecific symptoms of this condition often lead the patient to consult different specialists. A multidisciplinary approach is required and aimed at preventing an unnecessary increase of morbidity and mortality.
authors.affiliation: Servicio de Cirugía General y de Aparato Digestivo, Hospital General de Ciudad Real, Madrid, Spain. pablomensan@hotmail.com
authors.forename: Pablo
authors.initials: P
authors.lastname: Menéndez-Sánchez
authors.forename: Pedro
authors.initials: P
authors.lastname: Villarejo-Campos
authors.forename: David
authors.initials: D
authors.lastname: Padilla-Valverde
authors.forename: Susana
authors.initials: S
authors.lastname: Sánchez-García
authors.forename: Alberto
authors.initials: A
authors.lastname: Jara-Sánchez
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000063:Accidents, Traffic; D003106:Colon; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology; D006549:Hernia, Diaphragmatic, Traumatic / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D059685:Herniorrhaphy; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007421:Intestine, Small; D008875:Middle Aged; D011312:Pressure; D001261:Pulmonary Atelectasis / Q000209:etiology; D011706:Pyloric Antrum; D011859:Radiography; D013997:Time Factors