Missed Traumatic Rupture of the Diaphragm

Ryu,  Sang Woo; Chekar,  Jaykey; Yi,  In Ho; Seo,  Bo Ra; Park,  Seong Huek; Go,  Seong Ju

doi:2017.30.1.16

J Trauma Inj > Volume 30(1); 2017 > Article

Case Report

Journal of Trauma and Injury 2017;30(1):16-20.
DOI: https://doi.org/10.20408/jti.2017.30.1.16 Published online March 31, 2017.

Missed Traumatic Rupture of the Diaphragm

Sang Woo Ryu, Jaykey Chekar, In Ho Yi, Bo Ra Seo, Seong Huek Park, Seong Ju Go

¹Department of Thoracic and Cardiovascular Surgery, Mokpo Hankook Hospital, Chonnam, Korea.
²Department of Neurosurgery, Mokpo Hankook Hospital, Chonnam, Korea. cd1379@naver.com
³Department of Surgery, Mokpo Hankook Hospital, Chonnam, Korea.

Received: 21 September 2016 • Revised: 12 January 2017 • Accepted: 31 January 2017

Abstract

A 48-year-old man came to the emergency department with altered consciousness and hemoperitoneum following a pedestrian traffic accident. He underwent immediate emergency laparotomy, and on the second day, he required craniectomy because of increase of intracranial hemorrhage. A chest radiograph taken 7 days after admission, showed elevation of the right hemi-diaphragm, and follow-up chest CT showed a right-sided rupture of the diaphragm, which was surgically repaired. Rupture of the diaphragm can be easily overlooked and the diagnosis delayed, especially in unstable patients with multiple trauma or altered level of consciousness, as in the case reported here.

Key Words: Thoracic trauma; Traumatic diaphragm rupture