Left postpartum diaphragmatic hernia with colonic incarceration: a rare emergency after vaginal delivery

Abstract

A 34-year-old multiparous woman presented three days after spontaneous vaginal delivery with progressive abdominal distension and left-sided dyspnea. Computed tomography imaging revealed an 8 cm left posterolateral diaphragmatic hernia containing the splenic flexure and omentum, associated with upstream bowel dilation and massive ascites. Emergency laparotomy confirmed incarceration of viable colonic and omental structures. After gentle reduction, the defect was repaired using interrupted non-absorbable sutures, and thoracoabdominal drains were placed. The postoperative course was uneventful. This rare case highlights the importance of early imaging and prompt surgical intervention in postpartum diaphragmatic rupture.