Favorable outcome for both mother and fetus after successful management of gastric strangulation caused by ruptured diaphragmatic hernia in pregnancy

Rupture of diaphragmatic hernia is a very rare life threatening situation in pregnancy.it usually is followed by abstraction and strangulation of the herniated intra-abdominal organs such as colon, stomach and small bowel. Almost 50% of cases are misdiagnosed because of the non-specific manifestation of diaphragmatic hernia. The symptoms can be varied as the spectrum, from slight abdominal pain to acute abdomen or sever respiratory distress. High suspicion should be considered when the patient’s symptoms don’t response to usual supportive management. Delay in surgical intervention leads to high maternal and fetal mortality while timely diagnosis is resulted in favorable prognosis. Herein we present a pregnant woman with progressive epigastric pain and sever respiratory distress, who were undertaken thoracolaparotomy and gastrorrhaphy due to gastric strangulation via ruptured diaphragmatic hernia on 22nd week of gestation. Eventually both of them, mother and baby had a good prognosis. We concluded that although this condition is very rare but is very dangerous and it is mandatory to emergent surgery to avoid life threatening implications.