Late presentation of diaphragmatic hernia as small bowel obstruction in pregnancy

Spontaneous diaphragmatic hernia without any apparent history of trauma is a rare entity and is very difficult to diagnose. Only a few cases of rupture of diaphragm without any history of trauma have been recorded in the literature. Diaphragmatic hernias complicating pregnancy are not a common problem but they can have catastrophic consequences. They can present to the surgeon as a life‐threatening emergency or pose a management dilemma when detected incidentally. Complications include volvulus, incarceration, strangulation, haemorrhage and perforation of a hollow viscus. CT scan is the best imaging modality to diagnose diaphragmatic hernias. Surgery is the only treatment of diaphragmatic hernia in complicate cases irrespective of the status of pregnancy. The majority of these defects can be repaired safely with nonabsorbable sutures without the need for a prosthetic mesh as one in this case.