Abstract
Objective: To report a case of acute obstructive abdomen due to strangulation of occult diaphragmatic hernia. Case report: Male patient, with acute obstructive abdomen, transferred from the interior of the state and received, after about four days of evolution, in a hospital in the capital, with severe thoracoabdominal pain, significant abdominal distension and stopping the elimination of flatus and feces. Radiography showed poorly defined heterogeneous chest formation. Computed tomography showed intestinal content based on the left hemithorax, associated with exaggerated colon distension. Exploratory laparotomy was indicated, with successful reduction and correction of the diaphragmatic hernia. Final considerations: The clinical picture of diaphragmatic hernia varies considerably, depending on the biomechanics of the trauma, the physiological state and anatomical individuality of the patient, stage of evolution, size of the hernia, time elapsed from the trauma, which also determine its morbidity and mortality. It is important that the diagnosis and treatment are performed early in order to avoid late complications, such as obstruction and bowel loop infarction due to strangulation.