title: Laparoscopic management of a delayed traumatic diaphragmatic rupture complicated by bowel strangulation.
abstract: Traumatic rupture of the diaphragm (TDR) presents diagnostic difficulty, with basic radiological investigations discovering less than half of all cases. As a consequence, complications of diaphragmatic rupture may present long after the initial injury has occurred-the time delay obscuring diagnosis. Once discovered repair is necessary with previous reports advocating open repair. Here, we report a case of traumatic diaphragmatic rupture causing small bowel obstruction 20 years after initial injury. The patient, a young woman, underwent successful laparoscopic assisted diaphragmatic repair with small bowel resection. TDR is an unusual but important differential diagnosis of an acute abdomen. A high index of suspicion is required to avoid delayed diagnosis and increased mortality.
authors.affiliation: Department of Surgery, John Radcliffe Hospital, Oxford, UK mathewbaldwin@doctors.org.uk.
authors.forename: Mathew
authors.initials: M
authors.lastname: Baldwin
authors.affiliation: Department of Surgery, John Radcliffe Hospital, Oxford, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Dagens
authors.affiliation: Department of Upper GI and Bariatric Surgery, Churchill Hospital, Oxford, UK.
authors.forename: Bruno
authors.initials: B
authors.lastname: Sgromo