Laparoscopic management of large bowel obstruction caused by late post-traumatic diaphragmatic hernia: A case report

Introduction: Post-Traumatic Diaphragmatic Hernia (PTDH) is a relatively uncommon condition, often a consequence of blunt or penetrative trauma to the thoracic or abdominal cavity. Its onset can be either immediate or delayed following the injury, typically presenting with the herniation of abdominal organs into the thoracic cavity. Large Bowel Obstruction (LBO) is an infrequent manifestation of PTDH. Here, we report a case of late PTDH presenting with LBO that was successfully managed through a laparoscopic approach. Case presentation: A 49-year-old male patient presented with symptoms indicative of LBO seven years after sustaining a penetrative thoracoabdominal injury. Computed Tomography (CT) of his abdomen and pelvis revealed an incarcerated colon within a left diaphragmatic hernia, further corroborated by a significant history of a past thoracoabdominal stab wound. Diagnostic laparoscopy confirmed the diagnosis, which facilitated the relief of obstruction and repair of the diaphragmatic hernia. The patient exhibited a smooth recovery postsurgery without complications. Clinical discussion: An LBO presenting as a consequence of a post-traumatic diaphragmatic hernia is indeed rare. Given the mechanical nature of the obstruction, surgical intervention is the primary treatment strategy. Conclusion: Our case demonstrates that a laparoscopic approach is a safe and viable method for managing this condition.