title: Blunt traumatic hernia of diaphragm with late presentation.
abstract: BACKGROUND
  Diaphragmatic hernia after blunt trauma is an uncommon and often undiagnosed condition.
  
  
  OBJECTIVE
  We aimed to review patients who presented with delayed blunt traumatic hernia of diaphragm.
  
  
  METHODS
  In this retrospective study, the medical records of six patients treated for blunt diaphragmatic hernias who were admitted to Kashan Shahid Beheshti hospital between June 2007 and June 2011 were analyzed.
  
  
  RESULTS
  Six patients with mean age of 41 years were included in the study. Male to female ratio was 2:1. Mean duration between trauma and admission to the hospital was 6.5 years (2 - 26 years). Five patients had left-sided diaphragmatic hernia. Chest X-ray was obtained from all patients which was diagnostic in 50 percent of the cases (n = 4). Additional diagnostic imaging with computerized tomography (CT) was used in six patients and upper gastrointestinal (GI) contrast study was performed in one patient. All patients underwent thoracotomy incision. Mesh repair was utilized in one patient. The mean hospitalization time was 14.1 days. There was one postoperative death (16.7%).
  
  
  CONCLUSIONS
  Late presentation of blunt diaphragmatic hernia is an uncommon and challenging situation for the surgeon. Prompt diagnosis and treatment prevent serious morbidity and mortality associated with complications such as gangrene and perforation of herniated organ.
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Abdolhossein
authors.initials: A
authors.lastname: Davoodabadi
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Esmaeil
authors.initials: E
authors.lastname: Fakharian
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Mohammadzadeh
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Esmaeil
authors.initials: E
authors.lastname: Abdorrahim Kashi
authors.affiliation: Student Research Center Committee, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Azadeh Sadat
authors.initials: AS
authors.lastname: Mirzadeh
keywords: Diaphragm; Diaphragmatic Hernia; Trauma