Traumatic diaphragmatic rupture: delayed presentation following a SCUBA dive

2020 ◽  
Vol 13 (9) ◽  
pp. e234040
Author(s):  
Pei Yinn Toh ◽  
Simon Parys ◽  
Yuki Watanabe
Keyword(s):  
Abdominal Pain ◽  
Chest Pain ◽  
Laparoscopic Repair ◽  
Diaphragmatic Rupture ◽  
Delayed Presentation ◽  
Diagnostic Challenge ◽  
Traumatic Diaphragmatic Rupture ◽  
Breathing Apparatus ◽  
Life Threatening ◽  
Upper Abdominal

Traumatic diaphragmatic rupture (TDR) is a rare yet life-threatening occurrence that remains a diagnostic challenge for clinicians. Delayed presentation with associated strangulation of the contents, although uncommon, requires emergent management. A 42-year-old woman presented with constant, severe left-sided shoulder and chest pain, as well as associated upper abdominal pain following a self-contained underwater breathing apparatus (SCUBA) dive. A chest radiograph (CXR) and CT showed a left-sided diaphragmatic hernia containing stomach. She subsequently underwent a laparoscopic repair of the diaphragmatic defect and recovered well postoperatively.

scholarly journals 7 years-delayed presentation of a traumatic diaphragmatic rupture: laparoscopic repair

BMC Surgery ◽  
2013 ◽  
Vol 13 (Suppl 1) ◽  
pp. A2 ◽  
Author(s):  
Giovanni Aprea ◽  
Alfonso Canfora ◽  
Antonio Ferronetti ◽  
Antonio Giugliano ◽  
Francesco Guida ◽  
...  
Keyword(s):  
Laparoscopic Repair ◽  
Diaphragmatic Rupture ◽  
Delayed Presentation ◽  
Traumatic Diaphragmatic Rupture

scholarly journals Late traumatic diaphragmatic rupture complicated by haemothorax and strangulation of the stomach: A case report

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093086
Author(s):  
Jian-Chun Xiao ◽  
Li-Yuan Ma ◽  
Bing-Lu Li
Keyword(s):  
Penetrating Trauma ◽  
Diaphragmatic Rupture ◽  
Uneventful Recovery ◽  
Trauma Symptoms ◽  
Traumatic Diaphragmatic Rupture ◽  
Left Pleural Effusion ◽  
Threatening Condition ◽  
Diaphragmatic Repair ◽  
Life Threatening ◽  
High Index Of Suspicion

Traumatic diaphragmatic rupture (TDR) is an uncommon but life-threatening condition often caused by blunt or penetrating trauma. Symptoms may appear late resulting in delayed or missed diagnosis. We report here a case of a 28-year-old man who presented with left subcostal pain and vomiting after recently binge drinking alcohol. He had experienced bilateral rib fractures two years previously. Computed tomography (CT) showed massive left pleural effusion and pleural fluid drained by thoracentesis had a bloody appearance. The patient developed septic shock but emergency surgery showed no active bleeding. Enhanced-CT showed herniated stomach with ischemic necrosis in the left thoracic cavity. Total gastrectomy and diaphragmatic repair were successful and the patient had an uneventful recovery. A high index of suspicion is necessary when evaluating haemothorax, especially in patients with recent or previous thoraco-abdominal injury.

scholarly journals Acute Gastric Volvulus and Atrial Fibrillation with RVR: A Coincidence or Association

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Omar Nadhem ◽  
Omar Salh ◽  
Faisal Khasawneh
Keyword(s):  
Atrial Fibrillation ◽  
Abdominal Pain ◽  
Diaphragmatic Hernia ◽  
Gastric Volvulus ◽  
Shortness Of Breath ◽  
Threatening Condition ◽  
Acute Gastric Volvulus ◽  
Ventricular Response ◽  
Life Threatening ◽  
Upper Abdominal

Gastric volvulus is a rare and life-threatening condition that involves the abnormal rotation of the stomach around its axis by more than 180°. The association between acute gastric volvulus and atrial fibrillation with rapid ventricular response is rare with only few cases that have been reported. Our patient was an 86-year-old female who presented with upper abdominal pain, distension, nausea, and shortness of breath. Clinical and laboratory workup revealed acute gastric volvulus with diaphragmatic hernia. On presentation, she was also in atrial fibrillation with rapid ventricular response. She was successfully treated by laparotomy with reduction of the gastric volvulus and repair of the diaphragmatic hernia, with significant improvement.

scholarly journals Laparoscopic Repair of Diaphragmatic Rupture: A Case Report with Radiological and Surgical Correlation

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Patrick Nguyen ◽  
Bonnie Davis ◽  
Daniel D. Tran
Keyword(s):  
Abdominal Trauma ◽  
Laparoscopic Repair ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Diaphragmatic Rupture ◽  
Delayed Presentation ◽  
Vehicle Accident ◽  
Chest X Ray ◽  
The Many ◽  
High Degree

The leading cause of diaphragmatic rupture is penetrating abdominal trauma, including gunshot- and stab-related wounds; however, diaphragmatic rupture can also result from blunt trauma to the abdomen. The diagnosis can be difficult to make as the physical examination may be unremarkable, and imaging, that is, a conventional chest X-ray and/or CT imaging, may initially fail to reveal the injury. Failure to recognize diaphragmatic rupture can result in a delayed presentation, sometimes years later, with a potential catastrophic outcome. Therefore, prompt and swift diagnosis is critical to avoid this potential harmful scenario. Traditionally, repair is performed through a laparotomy or a thoracotomy incision. Owing to the many advances made in minimally invasive surgery, not only has laparoscopy become the modality of choice to diagnose diaphragmatic rupture due to its high degree of sensitivity and specificity, but it can provide simultaneous therapeutic intervention as well. We report a case of laparoscopic repair of a diaphragmatic rupture in a 22-year-old female who sustained blunt abdominal trauma during a motor vehicle accident.

scholarly journals Laparoscopic Treatment of a Rare Right Diaphragmatic Rupture with Small Bowel Herniation after Blunt Thoracic Trauma

2010 ◽  
Vol 2010 ◽  
pp. 1-2 ◽  
Author(s):  
H. Hoffmann ◽  
D. Oertli ◽  
O. Heizmann
Keyword(s):  
Small Bowel ◽  
Laparoscopic Approach ◽  
Diaphragmatic Rupture ◽  
Laparoscopic Treatment ◽  
Diaphragm Rupture ◽  
Traumatic Diaphragmatic Rupture ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Right ◽  
Delay Of Diagnosis

Blunt traumatic diaphragmatic rupture (BTDR) is a life-threatening condition with an incidence from 0,8%–1,6% in blunt trauma, mostly located on the left side. The main prognostic factors are severe side injuries and the delay of diagnosis. We present a rare case of a 68-year-old female, with an isolated right diaphragm rupture. The diagnosis was done with a delay of 4 days by thoracic radiographs, which showed a herniation of small bowel into the right thoracic cavity. A reposition of the small bowel and a closure of the diaphragmatic defect by running suture were carried out laparoscopicly. Although large prospective studies concerning the outcome of laparoscopic approach to right BTDR are still missing, we could show, that laparoscopy can be performed safely in right traumatic diaphragm rupture.

scholarly journals Fractured Ribs and the CT Funky Fat Sign of Diaphragmatic Rupture

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Iclal Ocak ◽  
Diane C. Strollo
Keyword(s):  
Multidetector Ct ◽  
Diaphragmatic Injury ◽  
Diaphragmatic Rupture ◽  
Rib Fracture ◽  
Diagnostic Challenge ◽  
Traumatic Diaphragmatic Rupture ◽  
Polytrauma Patients ◽  
Fractured Ribs ◽  
Omental Fat

Traumatic diaphragmatic rupture remains a diagnostic challenge for both radiologists and surgeons. In recent years, multidetector CT has markedly improved the diagnosis of diaphragmatic injury in polytrauma patients. Herein, we describe two cases of subacute presentation of traumatic diaphragmatic rupture from a penetrating rib fracture and subsequent intrathoracic herniation of omental fat, representing the CT “funky fat” sign.

Delayed presentation of traumatic diaphragmatic rupture with tension colothorax and strangulation of the transverse colon

2020 ◽  
Vol 13 (5) ◽  
pp. e233336
Author(s):  
Wassim Mousa ◽  
Christo Lapa ◽  
Cathleen Grossart ◽  
Asif Haq
Keyword(s):  
Emergency Department ◽  
Transverse Colon ◽  
Intensive Therapy ◽  
Rare Condition ◽  
Diaphragmatic Rupture ◽  
Uneventful Recovery ◽  
Emergency Laparotomy ◽  
Chest Drain ◽  
Delayed Presentation ◽  
Traumatic Diaphragmatic Rupture

A 26-year-old man presented to emergency department with respiratory distress. The initial diagnosis after chest X-ray was massive haemothorax, after insertion of a chest drain and further investigations, it turned up to be a rare case of a delay presentation of traumatic diaphragmatic rupture (DR) (after 1 year of the initial trauma). After excessive resuscitation of the patient in the emergency department, the patient underwent an emergency laparotomy which revealed ischaemic transverse colon herniated into the chest through a 7 cm diaphragmatic defect. Resection of the ischaemic bowel had been done, and the patient admitted to Intensive Therapy Unit (ITU) postoperatively. The patient had an uneventful recovery and discharged home on postoperative day 9. As DR after thoracoabdominal trauma is a rare condition that can be missed at initial presentation, we would like to highlight the main challenges in diagnosing and managing similar cases after reviewing related cases in the literature.

scholarly journals A rare case of traumatic diaphragmatic rupture with delayed presentation

2015 ◽  
Vol 6 (4) ◽  
pp. 294
Author(s):  
Yunus Shah ◽  
Avinash Rode ◽  
Vijay P Agrawal ◽  
BS Gedam ◽  
Prasad Bansod
Keyword(s):  
Rare Case ◽  
Diaphragmatic Rupture ◽  
Delayed Presentation ◽  
Traumatic Diaphragmatic Rupture

Doxycycline-Induced Gastric Perforation

2021 ◽  
pp. 000313482110474
Author(s):  
Yeahwa Hong ◽  
Christopher Staniorski ◽  
Dean Pollack ◽  
Steven Evans
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Chest Pain ◽  
Adverse Effects ◽  
Diagnostic Criteria ◽  
Gastric Perforation ◽  
Mucosal Injury ◽  
First Case ◽  
Life Threatening

Esophageal and gastric mucosal injuries are well-documented adverse effects of doxycycline leading to odynophagia, chest pain, and abdominal pain. There are no clear diagnostic criteria for such adverse effects; hence, the diagnosis depends heavily on thorough history. There is a paucity of literature describing life-threatening complications from doxycycline-induced mucosal injury, such as hemorrhage and perforation. We present the first case report describing a gastric perforation from doxycycline use.

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