Abstract

OSPINO- SAUMETT, Giovanni; MARTINEZ- BARBOSA, Patricia  and  VALVERDE- ROBERT, Raúl. Vólvulo gástrico intratorácico secundario a hernia diafragmática izquierda crónica postraumática. Acta méd. costarric [online]. 2005, vol.47, n.2, pp.94-96. ISSN 0001-6002.

Diaphragmatic rupture occurs in 5% of severe thoracoabdominal trauma and the herniation of abdominal visceral to the thorax happens in 45 to 60% of the cases. The stomach is the organ more frequently herniated². Complete intrathoracic gastric volvulus is uncommon in traumatic diaphragmatic hernia, in which the stomach undergoes organoaxial torsion predisposing to strangulation and necrosis. It may appear as a surgical emergency, though chronic patients with non specifics symptoms can be treated electively⁵. Traumatic diaphragmatic herniae are a diagnostic challenge to the surgeon. They are usually caused by blunt abdominal trauma, and less often by blunt thoracic trauma. They are located on the left side in 90% of all cases, probably secondary to the "buffer" effect of the liver on the right side. A rupture of the diaphragm is not diagnosed during the acute posttraumatic period in up to 40% of the cases, because it can remain asymptomatic or it may give nonspecific symptoms, that can appear hours or days after trauma. If the rupture stays unrecognized, a latency period ranging from hours to many years occurs until a significant thoracic prolapse of abdominal organs develops, causing a variety of symptoms. Once diagnosed a traumatic diaphragmatic hernia is an absolute and urgent indications for surgical therapy^1,6. We present the case of a 24 year old male with the history of toracoabdominal trauma, who had an intrathoracic gastric volvulus. He was handle surgically and did fine

Keywords : hernia diafragmática crónica traumática; vólvulo gástrico; diagnóstico; tratamiento quirúrgico.