Rupture of the diaphragm is known to be missed particularly when the patient has polytrauma and is admitted with Ortho/Neuro.This case has Rupture right diaphragm, herniation of liver occupying 3/4 th of right chest, left lung hyperventilated. I repaired the diaphragm through Thoraco abdominal incision. A piece of Composite mesh double layer was used to assist the defect closure as the leaves of diaphragm had contracted in 2 weeks. The initial Xrays chest hadn't shown diaphragm tear.
His spinal injury and admission with Orthopods was the reason for the missed diagnosis. Postoperative was very well. Went home on the wheelchair.
