Danso Kwabena A, Ekremet Kwame, Fiadzomor Sheba
Emergency Medicine, Komfo Anokye Teaching Hospital, Kumasi, GHA.
Emergency Medicine, University of Ghana Medical Centre, Accra, GHA.
Cureus. 2025 Jul 9;17(7):e87630. doi: 10.7759/cureus.87630. eCollection 2025 Jul.
This case report highlights the successful use of point-of-care ultrasound (POCUS) in a low- and middle-income country (LMIC) to achieve early diagnosis of a traumatic diaphragmatic hernia (DH), leading to timely surgical intervention. Traumatic DH, often resulting from blunt trauma, poses a diagnostic challenge due to its rarity, potential for occult presentation, and the presence of other life-threatening injuries that may obscure its detection. Delayed diagnosis can result in significant mortality, primarily due to cardiorespiratory compromise from visceral herniation. This report underscores the value of bedside ultrasound in resource-limited EDs as a critical tool for evaluating traumatic DH during the initial assessment, with the potential to improve patient outcomes in such settings. To the best of our knowledge, this is the first reported case in an LMIC in which POCUS played a pivotal role in the timely diagnosis and management of this condition.
本病例报告强调了在低收入和中等收入国家（LMIC）成功使用床旁超声（POCUS）实现创伤性膈肌疝（DH）的早期诊断，从而及时进行手术干预。创伤性DH通常由钝性创伤引起，由于其罕见性、隐匿性表现的可能性以及可能掩盖其检测的其他危及生命的损伤的存在，构成了诊断挑战。延迟诊断可能导致显著的死亡率，主要是由于内脏疝出导致的心肺功能不全。本报告强调了在资源有限的急诊科中床边超声作为初始评估期间评估创伤性DH的关键工具的价值，有可能改善此类情况下的患者结局。据我们所知，这是在LMIC中首次报道的病例，其中POCUS在该疾病的及时诊断和管理中发挥了关键作用。
