Diaphragmatic injury is an unusual life threatening complication of blunt trauma abdomen. However, a double blow injury occurring simultaneously such as diaphragmatic hernia and gastric injury is a rare injury. The association of gastric perforation along with diaphragmatic injury increases the mortality as well as morbidity manifold as compared to an isolated diaphragmatic injury. Traumatic diaphragmatic injury has variable clinical presentation ranging from pain in abdomen to respiratory distress and pneumonia. Preoperative diagnosis of diaphragmatic injury is quite demanding and often it goes undetected only to be found later intraoperatively. Although chest X-ray is still the best screening imaging modality to detect the diaphragmatic hernia but occasionally, especially for right-sided diaphragmatic injury, computed tomography and magnetic resonance imaging may be required to detect it in early stage. Here, we report a case of diaphragmatic hernia with gastric perforation sustaining blunt trauma in an 18 years old, young adult. Only a few cases of double blow injury with perforation of the diaphragm and stomach are reported in the literature. We aim to report this case because a prompt intervention with high degree of suspicion is the key to success in managing diaphragmatic hernia with gastric perforation following blunt trauma injury to the abdomen.

中文翻译：

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两次打击伤：钝性创伤后Following肌破裂伴胃穿孔

ph肌损伤是钝伤腹部的一种不寻常的危及生命的并发症。然而，同时发生的两次打击如diaphragm疝和胃部损伤是罕见的损伤。与孤立的diaphragm肌损伤相比，胃穿孔与diaphragm肌损伤的相关性增加了死亡率以及发病率。外伤性diaphragm肌损伤的临床表现不一，从腹部疼痛到呼吸窘迫和肺炎。diaphragm肌损伤的术前诊断非常苛刻，并且常常在手术后发现才被发现。尽管胸部X光片仍然是检测to肌疝的最佳筛查影像学方法，但偶尔（尤其是对于右侧diaphragm肌损伤）可能需要计算机断层扫描和磁共振成像才能在早期对其进行检测。在这里，我们报道了一名18岁的年轻成年人，伴有胃穿孔并伴有钝性创伤的of肌疝病例。在文献中仅报道了少数伴有the肌和胃穿孔的双重打击伤病例。我们的目的是报告此病例，因为对腹部钝器伤后胃穿孔的managing肌疝成功治疗的关键在于对其进行高度怀疑的及时干预。