Stale diaphragmatic injuries can easily lead to acute diaphragmatic hernia Abstract: Traumatic diaphragmatic hernia is caused by direct penetrating trauma or indirect heavier trauma to the chest or abdomen and can occur from sharp force injuries such as bullets, shrapnel foreign bodies and knife wounds, or closed injuries. Such as car accidents, falls from height, crush injuries and blast injuries. Traumatic diaphragmatic hernia is caused by direct penetrating trauma or indirect heavier trauma to the chest or abdomen, and can occur from sharp force injuries such as bullets, shrapnel foreign bodies and stab wounds, or from closed injuries. Such as car accidents, high falls, crush injuries and blast injuries, etc. Left-sided diaphragmatic hernia accounts for about 90% of cases, mostly occurring in the central tendon area of the left hemidiaphragm, with the protection of the liver under the right diaphragm and no true hernia sac. Clinical manifestations may include chest pain, chest tightness, dyspnea, abdominal pain, intestinal obstruction, shock and abdominal bowel sounds with alternating drums and turbid sounds on percussion. Signs such as mediastinal displacement and signs of peritoneal irritation are present. The diagnosis is often delayed due to the presence of additional injuries and atypical clinical manifestations, which can be complicated by herniation into strangulated organs, with a mortality rate of 30% to 50%. Therefore, early diagnosis and surgical repair are important. In this case, the diaphragm was penetrated after left-sided sharp-arm trauma, and only the chest wall was clinically sutured without deep exploration of the sharp-arm wound; pathological examination revealed scar tissue growth around the diaphragmatic hernia hole. Many patients are young and tolerant, and with no history of trauma at that time, they do not pay enough attention to their condition and fail to go to the hospital in time, thus delaying their condition, which is an important cause of death.