Presentation
Herniation of abdominal organs is present in 3–4% of people with abdominal trauma who present to a trauma center. Diaphragmatic injuries are present in 1–7% of people with significant blunt trauma and an average of 3% of abdominal injuries. [en.wikipedia.org]
We have focussed on mechanism of injury, duration, presentation and site of injury, visceral herniation, investigations and different approaches for repair. [ncbi.nlm.nih.gov]
Respiratory distress was the presenting feature in 10 cases [ 7, 11 – 13, 17, 21, 24 ]. Abdominal pain was the presenting feature in 3 cases [ 13, 17, 18 ]. [doi.org]
Entire Body System
Respiratoric
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Paroxysmal Cough
Violent paroxysmal coughing during tracheostomy was considered likely to have caused this rare complication. [ncbi.nlm.nih.gov]
Gastrointestinal
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Severe Abdominal Pain
A 28-year-old man presented as an emergency with shortness of breath and severe abdominal pain following a violent cough. [ncbi.nlm.nih.gov]
Omentum is also gangrenous and yet to be freed Click here to view Case 2 A 56-year-old female presented in the ER with a history of progressively severe abdominal pain and difficulty in breathing over 48 h. [afrjtrauma.com]
abdominal pain Abdominal guarding on examination Risk factors for peptic ulceration included smoking, high alcohol intake, and long term use of non-steroidal anti-inflammatory drugs Diagnosis Pneumoperitoneum – at laparotomy a perforated duodenal ulcer [radiologymasterclass.co.uk]
Bowel strangulation in a 19-year-old woman with severe abdominal pain and sepsis 7 years after severe blunt trauma. [doi.org]
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Left Flank Pain
He had a past history of fall at work 9 years ago and had then presented with left flank pain and chest pain on inspiration for 3 days. [doi.org]
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Pelvic Mass
This report describes the diagnosis and management of a patient with a delayed presentation of a ruptured right hemidiaphragm after a laparotomy for a pelvic mass. [ncbi.nlm.nih.gov]
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Chronic Abdominal Pain
A 40-year-old woman was admitted to our clinic because of chronic abdominal pain. Chest x-ray and computed tomography scan showed a migration of the large intestine into the left hemithorax. [ncbi.nlm.nih.gov]
Cardiovascular
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Chest Pain
We describe a case of an 18-year old patient admitted 2 hours after onset, presenting severe epigastric and left sided chest pain without any trauma history. [ncbi.nlm.nih.gov]
Neurologic
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Neglect
During the last 2 years, we treated three patients laparoscopically to address neglected diaphragmatic ruptures that caused herniation of the intraabdominal contents. [ncbi.nlm.nih.gov]
Workup
These ruptures may be recognized at the time of the initial trauma, but are diagnosed months or even years later during the workup for related symptoms. [ncbi.nlm.nih.gov]
X-Ray
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Left Pleural Effusion
The left posterior costophrenic sulcus was interrupted in all of the three patients with left pleural effusion. While it was associated with other findings of diaphragmatic injury, the "sinus cut-off sign" was the sole finding in one patient. [ncbi.nlm.nih.gov]
A computed tomography (CT) of the chest revealed a moderate left pleural effusion, compression of the left lung, and a rounded air-fluid cavity anteriorly (Figure 2A). [appliedradiology.com]
Axial contrast-enhanced CT image of upper abdomen reveals left pleural effusion that is abutting the herniated bowel (arrow) Click here to view Hypoattenuated hemidiaphragm and associated rib fractures: A hypoattenuated hemidiaphragm found in association [ijri.org]
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Chest X-Ray Abnormal
Home » Tutorials » Chest X-ray Tutorials » Chest X-ray Abnormalities » Introduction » 1 2 3 4 5 6 7 8 9 10 11 » Conclusion Key points Do not miss a pneumoperitoneum An obscured hemidiaphragm may be due to adjacent lung disease An abnormal diaphragm position [radiologymasterclass.co.uk]
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X-Ray Abnormal
Home » Tutorials » Chest X-ray Tutorials » Chest X-ray Abnormalities » Introduction » 1 2 3 4 5 6 7 8 9 10 11 » Conclusion Key points Do not miss a pneumoperitoneum An obscured hemidiaphragm may be due to adjacent lung disease An abnormal diaphragm position [radiologymasterclass.co.uk]
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Left Diaphragmatic Elevation
Chest X-ray showed a left diaphragmatic elevation. Computed tomography demonstrated a left haemo-pneumothorax, herniation of the stomach in the chest and a haemoperitonium. [ncbi.nlm.nih.gov]
Treatment
Traditionally, laparotomy or thoracotomy has been the treatment of choice for this condition. [ncbi.nlm.nih.gov]
Prognosis
The accurate diagnosis and prognosis of this pathology depend on a complete knowledge of the clinical and radiological presentation. [ncbi.nlm.nih.gov]
It may also be associated with malformations; in this event, the prognosis is more guarded than it would be otherwise. [15, 16, 17, 18] The causes of unilateral diaphragmatic paralysis are many. [emedicine.medscape.com]
Etiology
This study aimed to examine and improve our understanding of the etiology, clinical presentation, and management of DR. METHODS: This study was performed at the Emergency and General Surgery Department of Fondazione I.R.R.C.S. [ncbi.nlm.nih.gov]
Blunt trauma caused by motor vehicle accidents and penetrating trauma from gunshot and stab wounds are the major etiologic factors in most patients. [webmedcentral.com]
ETIOLOGY DI 0.63% National Trauma Data Bank (NTDB) 65 % Penetrating injury 35 % Blunt injury 4. [slideshare.net]
Epidemiology
Daoud pp. 179–182 Correction(s) for this article retraction notice Volume 32 Issue 6 Annals of Saudi Medicine 26 March 2019 Abstract Full text PDF Abstract Epidemiological aspects of scorpion stings in Al-Jouf Province, Saudi Arabia Bashir M. [annsaudimed.net]
The aim of our study was to evaluate the incidence of diaphragmatic injuries in the thoracic-abdominal trauma and discuss the epidemiology, diagnosis and treatment. [springerplus.springeropen.com]
Pathophysiology
Non-traumatic, spontaneous diaphragmatic rupture is a rare event whose pathophysiology is not known. [ncbi.nlm.nih.gov]
This preponderance for left-sided injuries is thought to be related to the protective effect of the bare area of the liver in contact with the diaphragm in the right thorax. 3 The pathophysiology in blunt trauma is due to the abrupt change in intraabdomonial [westjem.com]
It lays stress on the need to recognize the mechanisms involved in its pathophysiology as well as the diagnostic and therapeutic modalities. 2. [article.sciencepublishinggroup.com]
Abstract The pathophysiology and complications of blunt diaphragmatic rupture (BDR), an underdiagnosed and potentially life-threatening condition, are reviewed, and 19 CT signs that are suggestive or indicative of BDR are described and classified to facilitate [pubs.rsna.org]
Pathophysiology Currently, 80-90% of blunt diaphragmatic ruptures result from motor vehicle crashes (MVCs). Falls and other traumatic events rarely are implicated. [emedicine.com]
Prevention
Diaphragmatic hernia rupture during labor is a serious but rare complication that requires emergency surgery to prevent visceral perforation and cardio-respiratory failure. [ncbi.nlm.nih.gov]
They can interfere with the return of blood to the heart and prevent the heart from filling effectively, reducing cardiac output. [en.wikipedia.org]
The early use of supplemental imaging in traumatized patients reduces the chance of missed injury and prevents associated morbidity and mortality. [afrjtrauma.com]
However, the history of multi-trauma and the suspicion of diaphragmatic rupture prevented us from performing any invasive procedure before obtaining more imaging details. [rc.rcjournal.com]