In the patient presenting with bowel obstruction certain historical findings should raise the possibility of an occult diaphragmatic hernia.


Situations suggestive of diaphragmatic hernia in a patient with bowel obstruction:

(1) history of prior chest trauma, particularly stab wound

(2) presence of a left pleural density

(3) small bowel obstruction without abdominal scar or hernia

(4) large bowel obstruction in a young individual


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