Traumatic rupture of the diaphragm resulting in the sub-acute presentation of an incarcerated intra-thoracic transverse colon

The traumatic rupture of the diaphragm after blunt or penetrating injuries is a well described but uncommon entity. Its presentation in the form of herniated abdominal contents into the thoracic cavity is generally obscure and the recognition of this condition is often challenging. Although many cases remain asymptomatic, significant morbidity and mortality ensues with patients who present with incarceration, strangulation and eventual visceral compromise. Definitive guidelines in the management of traumatic diaphragmatic injuries are still lacking. This report outlines a case of sub-acute presentation of a traumatic diaphragmatic rupture in an elderly female following a motor vehicle accident that required urgent surgical intervention. We reviewed the pertinent literature, with an emphasis on the operative approach and the type of repair of the traumatic diaphragmatic defect.