Clinical Evaluation and Surgical Management of Diaphragmatic Eventration Mimicking Traumatic Hernia: A Case Report.

OBJECTIVE

Diaphragmatic eventration (DE) is a rare condition that can mimic a traumatic diaphragmatic hernia, particularly in trauma cases. We present a case of DE initially misdiagnosed as a diaphragmatic hernia following a road traffic accident, highlighting diagnostic challenges and surgical management.

CASE PRESENTATION: A 50-year-old man presented to the hospital after a road traffic accident with chest discomfort and decreased air entry on the left side. Chest X-ray revealed a left paracardiac opacity. Contrast-enhanced CT (CECT) of the thorax suggested a central diaphragmatic defect with herniation of the transverse colon and mesocolon. An exploratory laparotomy, however, revealed no diaphragmatic rupture but instead a central eventration measuring 10×5×7 cm containing bowel loops. The contents were reduced, and diaphragmatic plication was performed using non-absorbable polypropylene sutures. The patient's postoperative recovery was uneventful, and he was discharged on the eighth day. At follow-up, he remained asymptomatic.

CONCLUSION

This case underscored the importance of considering DE as a differential diagnosis in trauma patients. Surgical exploration is crucial for definitive diagnosis, and plication could provide an effective and durable management strategy.