HÉRNIA DIAFRAGMÁTICA TRAUMÁTICA PÓS-ATIVIDADE SEXUAL: RELATO DE CASO

ABSTRACT Introduction: Traumatic diaphragmatic hernia (TDH) is a rare condition, usually associated with high-energy blunt and penetrating trauma. However, cases resulting from blunt trauma due to sudden abdominal compression during sexual activity are extremely uncommon and can present diagnostic challenges due to the nonspecificity of the initial symptoms. Case Report: A previously healthy 21-year-old male patient presented with nausea, vomiting, asthenia, epigastralgia and severe anterior and posterior chest pain, exacerbated by respiratory movements, with sudden onset three days after sexual intercourse. Physical examination revealed an abolished vesicular murmur in the left hemithorax. Computed tomography showed a diaphragmatic hernia. The patient underwent exploratory laparotomy, and the stomach, transverse colon, great omentum and spleen were identified in the thorax, with reduction of the herniated loops and primary frenorrhaphy. Discussion: HDT has a variable presentation and can be underdiagnosed, especially when due to atypical injury mechanisms. Early diagnosis is essential to avoid complications such as ischemia and perforation of the herniated organs. Computed tomography is the exam of choice and surgery, using a minimally invasive or laparotomic approach, is mandatory. Conclusion: Despite its rarity, HDT should be considered in the differential diagnosis of chest pain following blunt trauma, regardless of the mechanism involved. Early recognition and appropriate surgical treatment are fundamental to reducing morbidity and mortality. Keywords: Traumatic diaphragmatic hernia; Exploratory laparotomy; Traumatic diaphragmatic rupture; Diaphragm injury; Abdominal trauma.