Tension pneumothorax as a presentation of traumatic diaphragmatic hernia

Spontaneous pneumothorax and tension pneumothorax are being increasingly recognized as complications of traumatic diaphragmatic hernia, particularly when presentation is delayed. This underscores the importance of suspecting the diagnosis of diaphragmatic hernia in patients with a recent or remote history of blunt or penetrating trauma to the chest or abdomen and an unusual or an atypical thoracic process. Once the diagnosis is suspected, confirmation with contrast studies, CT, or MRI should be obtained and surgical repair undertaken without delay.