Blunt Diaphragmatic Rupture: A Case Report and Review of the Literature

We present a 19-year-old male motorcyclist slipped and bumped his back against the asphalt. He was presented to our emergency department with dramatically deteriorated vital signs. Chest x-ray and computed tomography (CT) showed left diaphragmatic rupture with intrathoracic herniation of stomach and spleen. Exploratory laparotomy was performed. Our article aims to remind the physical and radiological findings of the diaphragmatic rupture to emergency physicians.

[1]  T. Razek,et al.  The current status of traumatic diaphragmatic injury: lessons learned from 105 patients over 13 years. , 2008, The Annals of thoracic surgery.

[2]  Kavouras Nikolaos,et al.  Traumatic avulsion of kidney and spleen into the chest through a ruptured diaphragm in a young worker: a case report , 2007, Journal of medical case reports.

[3]  G. Sangster,et al.  Diaphragmatic rupture: a frequently missed injury in blunt thoracoabdominal trauma patients , 2007, Emergency Radiology.

[4]  M. Kantarci,et al.  Imaging of diaphragmatic rupture after trauma. , 2006, Clinical radiology.

[5]  Kenneth Totz Images in emergency medicine. Diaphragmatic rupture. , 2004, Annals of Emergency Medicine.

[6]  M. Nance,et al.  Thickening of the diaphragm: a new computed tomography sign of diaphragm injury. , 1999, Journal of thoracic imaging.

[7]  R. Byard,et al.  Posttraumatic diaphragmatic hernia and death--etiologic factor or putrefactive artifact? , 1999, The American journal of forensic medicine and pathology.

[8]  A. Mearns,et al.  Traumatic rupture of diaphragm. , 1995, The Annals of thoracic surgery.

[9]  H. Minagi,et al.  Large-bowel obstruction resulting from traumatic diaphragmatic hernia: imaging findings in four cases. , 1994, AJR. American journal of roentgenology.

[10]  P. Kearney,et al.  Blunt rupture of the diaphragm: mechanism, diagnosis, and treatment. , 1989, Annals of emergency medicine.

[11]  M. Orringer,et al.  Congenital and traumatic diaphragmatic hernias exclusive of the hiatus , 1975 .

[12]  C. Fischer,et al.  Blunt abdominal trauma and a diaphragmatic injury. , 2007, The Journal of emergency medicine.

[13]  A. Nchimi,et al.  Helical CT of blunt diaphragmatic rupture. , 2005, AJR. American journal of roentgenology.

[14]  D. Healy,et al.  Delayed Discovery of Diaphragmatic Injury After Blunt Trauma: Report of Three Cases , 2004, Surgery Today.

[15]  M. Kirshenbaum Diaphragmatic rupture due to blunt trauma: sensitivity of plain chest radiographs. , 1991, AJR. American journal of roentgenology.