CTICasesDelayed Traumatic Diaphragmatic Hernia
Imaging findings
Initial chest CT following trauma shows rib fractures but no visible diaphragmatic defect. A follow-up CT scan performed days later reveals a new focal defect in the left hemidiaphragm with a small amount of herniated fat extending into the thoracic cavity, adjacent to a left pleural effusion.
Key takeaways
Diaphragmatic injuries from blunt trauma can be subtle on initial imaging, particularly when masked by mechanical ventilation or lacking immediate visceral herniation. A delayed or progressive tear can manifest days later as the diaphragm defect widens, allowing fat or abdominal contents to herniate.
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