Iatrogenic diaphragmatic hernia in infants: Potentially catastrophic when overlooked

•Acquired diaphragmatic hernia are a rare occurrence in infants•Iatrogenic diaphragmatic hernia case resulting in strangulated bowel•Soft pleural catheters are suitable alternatives to stiff bore chest tubes

Acquired diaphragmatic hernias are a rare occurrence. They can result from blunt, penetrating or inadvertent iatrogenic injury. When overlooked they can potentially be catastrophic. We report a case of iatrogenic diaphragmatic hernia in a six-month old infant presenting with acute respiratory distress as a result of strangulated bowel herniating into the left hemithorax caused from a traumatic chest tube insertion in the neonatal period.