• Saâd Rifki Jai, Fatimazahra Bensardi, Ahmed Hizaz, Farid Chehab, Driss Khaiz, and Abdelmajid Bouzidi.
• Department of Surgery III, Ibn Rochd University Hospital, Casablanca, Morocco. saadjai@yahoo.fr
• Arch. Gynecol. Obstet. 2007 Sep 1; 276 (3): 295-8.

IntroductionDiaphragmatic hernia during pregnancy is uncommon and is usually traumatic in origin, epigastric pain, and vomiting could be the initial symptoms of herniation of gastrointestinal contents, with a risk of strangulation and ischaemia, leading to respiratory distress due to collapse of the lung.MethodsCase report.ResultsA 27-year-old woman, with undiagnosed traumatic diaphragmatic hernia who presented, at 32 weeks' gestation, epigastric pain, vomiting and tachycardia, immediate post-partum course was complicated by respiratory failure. A chest X-ray showed an air fluid level in the left lung which was wrongly diagnosed as an hydropneumothorax, in front of respiratory symptoms exacerbation, an inappropriate thoracic drainage tube was accidentally placed into the herniated stomach leading to perforation of this last. An emergency laparotomy discovered a 2/3 of the stomach, transverse colon and greater omentum herniated in the left hemithorax through a defect of the left hemidiaphragm.ConclusionThe diagnosis should then be considered early, and chest radiography with a nasogastric tube is the first technique to prefer and may be helpful to confirm the diagnosis.

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