scholarly journals Delayed Presentation of Traumatic Diaphragmatic Rupture with Herniation of the Left Kidney and Bowel Loops

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Amiya Kumar Dwari ◽  
Abhijit Mandal ◽  
Sibes Kumar Das ◽  
Sudhansu Sarkar
Keyword(s):  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Major Trauma ◽  
Left Kidney ◽  
Diaphragmatic Rupture ◽  
Delayed Presentation ◽  
Traumatic Diaphragmatic Hernia ◽  
Traumatic Diaphragmatic Rupture ◽  
A Minor

Rupture of the diaphragm mostly occurs following major trauma. We report a case of delayed presentation of traumatic diaphragmatic hernia on the left side in a 44-year-old male who presented two weeks after a minor blunt trauma. Left kidney and intestinals coils were found to herniate through the diaphragmatic tear. This case demonstrates the importance of considering the diagnosis in all cases of blunt trauma of the trunk. It also illustrates the rare possibility of herniation of kidney through the diaphragmatic tear.

scholarly journals Delayed Traumatic Diaphragmatic Hernia With Bacterial Pleuritis

2016 ◽  
Vol 101 (5-6) ◽  
pp. 270-274
Author(s):  
Yu Ohkura ◽  
Shusuke Haruta ◽  
Yusuke Maeda ◽  
Hisashi Shinohara ◽  
Masaki Ueno ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diaphragmatic Hernia ◽  
Diaphragmatic Rupture ◽  
Traumatic Diaphragmatic Hernia ◽  
Hernia Mesh ◽  
Reactive Protein ◽  
Traumatic Diaphragmatic Rupture ◽  
Absorbable Sutures ◽  
Abdominal Blunt Trauma ◽  
Traumatic Pneumothorax

Thoraco-abdominal blunt trauma may cause traumatic diaphragmatic hernia. Here, we report a case of delayed traumatic diaphragmatic rupture with herniation of multiple viscera along with bacterial pleuritis without perforation or necrosis. A 72-year-old man presented with severe left-sided chest pain and dyspnea following a fall in the bathroom on the previous day; he had hit the left side and back of the chest against a faucet. Computed tomography (CT) revealed pneumoderma, mediastinal emphysema, pneumothorax, and fractures of the 8th–11th left ribs. We diagnosed traumatic pneumothorax, which was treated by a thoracostomy tube inserted into the pleural space. Approximately 6 months later, he presented again with fever (39.2°C), dyspnea, and coughing. The white blood cell count and C-reactive protein were elevated at 20.3 × 103/μL and 28.7 mg/dL, respectively. A CT scan revealed left-sided pleural effusion and diaphragmatic hernia. Thoracocentesis was performed for the pleural effusion, and bacterial cultivation tests revealed Bacteroides fragilis; therefore, antibiotics were administered for 3 weeks. Subsequently, diaphragmatic hernia repair was performed. Laparotomy via a left subcostal incision revealed a defect measuring 60 × 60 mm; this was repaired with uninterrupted absorbable sutures without using a hernia mesh to avoid infection. The postoperative course was uneventful, and no recurrence was noted at the 1-year follow-up. We repaired delayed traumatic diaphragmatic rupture with herniation of multiple viscera by simple suturing without using a hernia mesh following the treatment of associated bacterial pleuritis.

scholarly journals Traumatic Diaphragmatic Rupture, Incidence, Presentation, and Outcome: تمزق الحجاب الحاجز الرضحي؛ مدى شيوع الإصابة والعرض والنتيجة

2021 ◽  
Vol 5 (3) ◽  
pp. 98-84
Author(s):  
Waleed Mohammed Gialan, Yasser Abdurabu Obadiel, Abdulrazzak Waleed Mohammed Gialan, Yasser Abdurabu Obadiel, Abdulrazzak
Keyword(s):  
Prospective Study ◽  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Penetrating Trauma ◽  
Length Of Hospital Stay ◽  
Diaphragmatic Rupture ◽  
Associated Injuries ◽  
Traumatic Diaphragmatic Rupture ◽  
The Right ◽  
Time Of Presentation

Objective: The aim of this prospective study is to highlight the incidence of a traumatic diaphragmatic rupture occurring in thoraco-abdominal penetrating or blunt trauma, and discuss their presentation and outcome Methods: We performed a prospective study, between 1st January 2017 to 30th June 2020 at the Department of General Surgery of the Al-Thawra Modern General Hospital, and 48-Modrn hospital -Sana'a city -Yemen. We included all the patients who were diagnosed and admitted with traumatic diaphragmatic rupture during the study period. Data included demographics, mechanism of injury, associated injuries, time of presentation post- trauma, length of hospital stay and ICU, ventilator days, management, postoperative complication, and outcomes. The variables were analyzed and compared for patients. Result: A total of 38 patients had traumatic diaphragmatic injury of (1843) thoracoabdominal trauma (2.1%)(855 blunt trauma & 988 penetrating trauma), 31 patients (81.6%) have sustained penetrating trauma, while only 7 patients (18.4%) have blunt trauma. There were 33 male patients (86.8%) and 5 female patients (13.2%) with a mean age of 25 years (range 3–52 years), the location of rupture was 30 patients (78.9%) on the left-sided, and 8 patients (21.1%) on right-sided, 4 patients presented early with a diaphragmatic hernia, and 5 patient presented late with diaphragmatic hernia. Associated injuries were presented in 36 patients (94.7%). The diagnosis was preoperatively established in (36.8%), and intraoperative (63.2%). The diaphragmatic rupture was repaired with interrupted nonabsorbable sutures. Postoperative complications were observed in 23 patients (60.5%). Mortality was observed in 4 patients (10.5%). The outcome affected by associated injuries hemo/pneumothorax, rib fractures/lung contusion, hollow viscous injury, post-operative complication, time of presentation post- trauma, and hemodynamically state before admission. Conclusion: Traumatic diaphragmatic rupture, usually masked by multiple associated injuries which aggravate the condition of patients and are responsible for morbidity and mortality. The left-sided is involved more than the right-sided.

scholarly journals Strangulated Tension Viscerothorax with Gangrene of the Stomach in Missed Traumatic Diaphragmatic Rupture

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Uvie Onakpoya ◽  
Akinwumi Ogunrombi ◽  
Anthony Adenekan ◽  
William Akerele
Keyword(s):  
Treatment Outcomes ◽  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Anterior Wall ◽  
Diaphragmatic Rupture ◽  
The Body ◽  
Rare Occurrence ◽  
Traumatic Diaphragmatic Rupture ◽  
Poor Treatment ◽  
Diaphragmatic Hernias

Acquired diaphragmatic hernias are usually posttraumatic in occurrence. In patients who have blunt trauma and associated diaphragmatic hernia, the diagnosis may be missed or delayed, often leading to poor treatment outcomes. We present a rare occurrence of tension viscerothorax due to missed traumatic diaphragmatic rupture in a 25-year-old woman whose condition was complicated by gangrene and perforation of the fundus as well as questionable viability of the anterior wall of the body of the stomach. The patient had a successful emergency transabdominal suture plication of the diaphragm and gastroplasty and has remained symptomless 3 months postoperatively.

scholarly journals Delayed presentation of a patient with a ruptured diaphragm complicated by gastric incarceration and perforation after apparently minor blunt trauma

CJEM ◽  
2004 ◽  
Vol 6 (04) ◽  
pp. 277-280 ◽  
Author(s):  
Brian K.P. Goh ◽  
Andrew S.Y. Wong ◽  
Khoon-Hean Tay ◽  
Michael N.Y. Hoe
Keyword(s):  
Blunt Trauma ◽  
Nasogastric Tube ◽  
Traffic Accidents ◽  
Major Trauma ◽  
Road Traffic ◽  
Delayed Presentation ◽  
Road Traffic Accidents ◽  
Gastric Incarceration ◽  
Repeat Imaging ◽  
Ruptured Diaphragm

ABSTRACTRupture of the diaphragm is almost always due to major trauma and is most commonly associated with road-traffic accidents. We report a case of delayed presentation of a 35-year-old woman with a ruptured diaphragm, 11 days following apparent minor blunt trauma. This case illustrates how the diagnosis of ruptured diaphragm can be missed and demonstrates the importance of considering this diagnosis in all cases of blunt trauma to the trunk. It also demonstrates the potential pitfall of misinterpreting the chest radiograph, and the value of repeat imaging after insertion of a nasogastric tube.

Delayed presentation of traumatic diaphragmatic hernia

1986 ◽  
Vol 4 (1) ◽  
pp. 1-7 ◽  
Author(s):  
William L. Saber ◽  
Ernest E. Moore ◽  
Alan R. Hopeman ◽  
William E. Aragon
Keyword(s):  
Diaphragmatic Hernia ◽  
Delayed Presentation ◽  
Traumatic Diaphragmatic Hernia

scholarly journals Delayed presentation of post traumatic diaphragmatic hernia

2011 ◽  
Vol 2011 (7) ◽  
pp. 6-6 ◽  
Author(s):  
S Lal ◽  
Y Kailasia ◽  
S Chouhan ◽  
APS Gaharwar ◽  
GP Shrivastava
Keyword(s):  
Diaphragmatic Hernia ◽  
Delayed Presentation ◽  
Traumatic Diaphragmatic Hernia ◽  
Post Traumatic

scholarly journals Traumatic Diaphragmatic Hernia: Management and Review

2021 ◽  
pp. 1-3
Author(s):  
Sweety kumari ◽  
Keyword(s):  
Early Diagnosis ◽  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Diagnosis And Treatment ◽  
Therapeutic Tool ◽  
Penetrating Injuries ◽  
Traumatic Diaphragmatic Hernia ◽  
Delay In Diagnosis ◽  
Life Threatening ◽  
Suspicion Index

Traumatic diaphragmatic injury (TDI) is a fairly uncommon with incidence of 0.8 and 1.6 %, commonest fallowing blunt trauma abdomen. Right-side have higher mortality rate compared to left side and penetrating injuries. It present as occult to obvious. Laparoscopy offers diagnostic and therapeutic tool of care. Lack of awareness of the condition may delay in diagnosis, results life threatening complications. Missed hernia is a known complication of blunt trauma as acute diagnosis can be difficult to ascertain. An early diagnosis and treatment lead to better outcome. In present study CECT revealed acute diaphragmatic hernia, bilateral pleural effusion and hair line fracture of right tibia on skiagram limb. Because of uncertainty in diagnosis of acute diaphragmatic hernia or rupture surgeons faces challenges for the management, high suspicion index required to diagnose the cases. An early diagnosis and treatment lead to better outcome

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.

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