Faye Papa Mamadou, Kengne Ulrich Igor Mbessoh, Thiam Ousmane, Diop Mouhamadou Laye, Mekontso Joël Gabin Konlack, Gueye Mouhamed Moustapha, Ly Seydy, Fall Amacoumba, Diop Mame Dieme, Mbueda Christophe, Makam Naomi, Toure Alpha Oumar, Cisse Mamadou
Department of Surgery, Dalal Jamm National Hospital, Dakar, Senegal.
Department of Surgical Oncology, Cheick Anta Diop University, Dakar, Senegal.
Case Rep Surg. 2025 Mar 26;2025:2527619. doi: 10.1155/cris/2527619. eCollection 2025.
Post-traumatic diaphragmatic hernia (PTDH) is defined as the migration of intra-abdominal organs into the chest through a pathological defect in the diaphragm caused by trauma. PTDH is a rare condition, occurring in 3%-7% of all thoracoabdominal injuries. Approximately 14.6% of PTDH cases present months to years after the initial trauma. Cases of delayed PTDH complicated by bowel obstruction and perforation are exceedingly uncommon, with a reported prevalence of 0.17%-6%. In Africa, fewer than 10 cases of delayed PTDH have been documented over the past three decades. Despite the availability of published reports, there are no established practice guidelines for managing PTDH. Here, we present a case of delayed PTDH that manifested as acute bowel obstruction 12 years after a gunshot wound to the chest. The condition led to a fatal postoperative outcome. This case highlights the critical need for clinicians to consider PTDH in patients with a history of trauma presenting with acute bowel obstruction and underscores the importance of urgent surgical management to prevent fatal complications.
创伤后膈疝（PTDH）定义为腹腔内器官通过创伤导致的膈肌病理性缺损移入胸腔。PTDH是一种罕见病症，在所有胸腹联合伤中发生率为3%-7%。约14.6%的PTDH病例在初次创伤数月至数年后出现。延迟性PTDH合并肠梗阻和穿孔的病例极为罕见，报告患病率为0.17%-6%。在非洲，过去三十年记录的延迟性PTDH病例不到10例。尽管有已发表的报告，但尚无管理PTDH的既定实践指南。在此，我们报告一例延迟性PTDH病例，该病例在胸部枪伤12年后表现为急性肠梗阻。该病症导致术后致命结局。本病例突出了临床医生在有急性肠梗阻表现的创伤患者中考虑PTDH的迫切需要，并强调了紧急手术治疗以预防致命并发症的重要性。
