CTICasesPost-Traumatic Diaphragmatic Hernia
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Imaging findings
Chest radiograph demonstrates a focal, low-density, pleural-based mass-like opacity along the left lateral chest wall and a metallic bullet fragment lodged in the posterior thoracic soft tissues. Contrast-enhanced CT confirms a focal transdiaphragmatic hernia containing peritoneal fat and small mesenteric vessels herniating through a defect in the left hemidiaphragm along the path of the prior gunshot wound.
Key takeaways
Diaphragmatic injuries from penetrating trauma (such as gunshot or stab wounds) are often clinically silent at the time of initial presentation but can lead to delayed diaphragmatic herniation of abdominal fat or viscera. Correlation of pleural-based masses with prior trauma history and CT demonstration of a diaphragmatic collar sign are diagnostic.
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