DOI: https://doi.org/10.36347/sasjs.2026.v12i04.015

Pages: 326-328

Congenital diaphragmatic hernia (CDH) diagnosed in adulthood is a rare condition, often revealed by non-specific symptoms. We report the case of a 45-year-old chronic smoker presenting with epigastric pain evolving over three years. Chest radiography was unremarkable, whereas thoracoabdominal computed tomography revealed a left posterolateral diaphragmatic hernia containing omental fat, without signs of visceral compromise. The patient underwent surgical repair through an upper midline laparotomy. Intraoperative findings revealed a 5 cm left diaphragmatic defect containing omentum with multiple omento-diaphragmatic and omento-pleural adhesions, requiring difficult adhesiolysis prior to reduction and closure of the defect using interrupted non-absorbable sutures. The postoperative course was uneventful. This case highlights the limitations of imaging in assessing adhesions and emphasizes the importance of considering the chronicity of the hernia when selecting the surgical approach.