Traumatic avulsion of the right diaphragm from the lumbocostal arch is a very 
rare lesion. The authours report the case of a 27-year-old man who had suffered 
a severe polytrauma with blunt thoracic injury, fracture of the lumbar spine, 
Malgaigne-type fracture of the pelvis and fracture of the femoral shaft on the 
right side, 10 years before. At the time of injury the lesion of the diaphragm 
went unnoticed. The diagnosis was made 10 years later when the patient was 
referred for chronic right thoracic pain combined with postprandial abdominal 
distension and crampy pain in the abdomen. The chest radiogram and CT-scan 
showed displacement of the right kidney and most of the right colon into the 
thorax due to avulsion of the diaphragm from its dorsal insertion on the 
lumbocostal arch. Surgical repair was necessary to obtain relief from pain and 
to prevent intestinal obstruction. Reduction of the hernia, reinsertion of the 
diaphragm to the lumbocostal arch and reinforcement of the repair with a prolene 
mesh prosthesis was performed through a right thoracophrenolumbotomy incision.