Delayed Symptomatology in Traumatic Diaphragmatic Hernia with a Note on Eventration.

new syndrome, traumatic diaphragmatic hernia with symptoms developing several months after injury. He described the case of a French artillery captain who was shot in the chest by an arquebus. The missile penetrated the sternum, traversed the muscular portion of the diaphragm, and made an exit through the left fifth interspace. The captain’s external wound healed and he returned to duty. Thereafter, he had colic whenever he ate regular sized meals, so he resorted to small meals at frequent intervals. Eight months after the injury, he developed an attack of severe colic; he failed to respond to medical measures and expired two days later. Post-mortem examination showed that much of the colon had passed into the chest through a hole in the diaphragm that would admit only a little finger. It is the purpose of this paper to amplify on Pare’s observation, that a patient with a history of a serious trauma, who complains of intermittent colic even some ‘ears after the accident, may have a correctable diaphragmatic defect. Three cases of traumatic diaphragmatic hernia seen at the Dearborn Veterans Administration Hospital during the past year, and one case that was seen in 1958, illustrate this phenomenon. A case of eventration of the diaphragm will also he presented, for we have found it diffIcult to separate this entity from diaphragmatic hernia by roentgen examination. When this relatively innocuous lesion is confused (as it frequently is) with the potentially more dangerous condition of traumatic diaphragmatic hernia, effective treatment may be delayed until too late. CAsE 1: