Presentation
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
- Turkish
Turkish Journal of Trauma and Emergency Surgery. 2006, 12 (1): 68-70. PubMed Google Scholar Rafi M, Marudanayagam R, Moorthy K, Yoong K: Delayed presentationof a diaphragmatic rupture as intra-thoracic gastric volvulus. [doi.org]
- Inguinal Hernia
PubMed Central View Article PubMed Google Scholar Fitzgibbons RJ, Salerno GM, Filipi CJ, Hunter WJ, Watson P: A laparoscopic intraperitoneal onlay mesh technique for the repair of an indirect inguinal hernia. [doi.org]
Respiratoric
- Pleural Effusion
The "sinus cut-off sign" is useful and can increase the CT detection of acute diaphragmatic injury associated with pleural effusion. [ncbi.nlm.nih.gov]
There was herniation of one-third of the stomach into the lower chest and a bloody pleural effusion. [appliedradiology.com]
In our experience, the postoperative morbidity was 30.4% and the pulmonary complications including atelectesis, ARDS, pleural effusion and empyema were the most encountered complications. [academic.oup.com]
View Article PubMed Google Scholar Wu YS, Lin YY, Hsu CW, Chu SJ, Tsai SH: Massive ipsilateral pleural effusion caused by transdiaphragmatic intercostal hernia. Am J Emerg Med. 2008, 26 (2): e253-254. 10.1016/j.ajem.2007.04.018. [doi.org]
- Cough
We present herein a rare case of diaphragmatic rupture due to violent coughing during tracheostomy. A 73-year-old man was admitted with cough, hoarseness and dysphagia caused by a huge laryngeal cancer obstructing the airways. [ncbi.nlm.nih.gov]
Gastrointestinal
- Abdominal Pain
We present herein a patient who suffered from abdominal pain and dyspnea years after a motor vehicle accident. A chest computed tomography (CT) demonstrated diaphragmatic rupture with intrapericardial herniation of intraabdominal organs. [ncbi.nlm.nih.gov]
- Nausea
In most cases, early symptoms are missed, but in the further posttraumatic period, patients experience recurrence of pulmonary dysfunction or intestinal symptoms such as obstruction, nausea, and pain. [ncbi.nlm.nih.gov]
CLASSIC CASES Late presentation of diaphragm rupture following blunt thoracic trauma Case Presentation A 67 year old woman was admitted via the emergency department complaining of nausea, vomiting and abdominal pain after meals. [trauma.org]
This was associated with nausea, shortness of breath, and sweating. The patient could not stand the pain and was brought to the emergency room. [appliedradiology.com]
Case Summary A 35-y-old woman presented to our department with severe and acute pain located in her left shoulder, lower thoracic region, and epigastrium, dyspnea, productive cough, and nausea and vomiting of 3 d duration. [rc.rcjournal.com]
He initially complained of diffuse thoraco-abdominal pain, dyspnea and nausea. 12hours after admission, he was transferred to the visceral surgical unit and a rapid physical examination was performed. [article.sciencepublishinggroup.com]
- 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]
X-rays) Clinical information Acute, severe 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 [radiologymasterclass.co.uk]
We present two adults with complaints of severe acute abdominal pain and a history of high-speed vehicular trauma whose definitive diagnoses were delayed. [afrjtrauma.com]
Bowel strangulation in a 19-year-old woman with severe abdominal pain and sepsis 7 years after severe blunt trauma. [doi.org]
- 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]
Cardiovascular
- Chest Pain
We present the case of a 35-year-old pregnant woman presenting an unspecific clinical picture of intense chest pain and hypoventilation at 15 weeks of pregnancy. She was diagnosed with diaphragmatic rupture complicated by a gastric rupture. [ncbi.nlm.nih.gov]
- Thrombosis
The appearances of the splenic vein on the scan were consistent with thrombosis. Conclusion Left sided portal hypertension as a result of isolated splenic vein thrombosis secondary to trauma is rare. [biomedcentral.com]
Intrapleural herniation of large intestine has been reported as CT scan findings of intrapleural herniation of large intestine and abundant pleural effusion [ 21 ], Intrathoracic displacement of liver[ 12, 15, 33 ], intrathoracic spleen with splenic vein thrombosis [wjes.biomedcentral.com]
Skin
- Ulcer
The patient then underwent an explorative laparotomy that confirmed duodenal ulcer perforation. [ncbi.nlm.nih.gov]
[…] included smoking, high alcohol intake, and long term use of non-steroidal anti-inflammatory drugs Diagnosis Pneumoperitoneum – at laparotomy a perforated duodenal ulcer was found Diaphragm contour abnormalities The normal hemi-diaphragms form distinct [radiologymasterclass.co.uk]
He volunteered a history of recurrent epigastric pain in the past 3 years for which he received treatment for peptic ulcer disease with no significant relief of his symptoms. [afrjtrauma.com]
Perforated Transverse Colon 3 [ 16, 19, 21 ] Splenic flexure 2 [ 12, 18 ] Splenic flexure cancer 1 [ 4 ] Intrathoracic Splenosis 2 [ 8, 35 ] Spleen 2 [ 12, 22 ] Right hepatic lobe 6 [ 2, 7, 15, 31 – 33 ] Small Bowel 1 [ 31 ] Stomach/Perforated gastric ulcer [doi.org]
Urogenital
- 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]
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
- 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]
Sinus cut-off sign" occurs in the presence of blunt diaphragmatic hernia with pleural effusion and is a variant of dependent viscera sign. [ijri.org]
- 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]
- 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]
Pleura
- Pleural Effusion
The "sinus cut-off sign" is useful and can increase the CT detection of acute diaphragmatic injury associated with pleural effusion. [ncbi.nlm.nih.gov]
There was herniation of one-third of the stomach into the lower chest and a bloody pleural effusion. [appliedradiology.com]
In our experience, the postoperative morbidity was 30.4% and the pulmonary complications including atelectesis, ARDS, pleural effusion and empyema were the most encountered complications. [academic.oup.com]
View Article PubMed Google Scholar Wu YS, Lin YY, Hsu CW, Chu SJ, Tsai SH: Massive ipsilateral pleural effusion caused by transdiaphragmatic intercostal hernia. Am J Emerg Med. 2008, 26 (2): e253-254. 10.1016/j.ajem.2007.04.018. [doi.org]
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]
ETIOLOGY DI 0.63% National Trauma Data Bank (NTDB) 65 % Penetrating injury 35 % Blunt injury 4. [slideshare.net]
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]
Epidemiology
We undertook this study to analyze the epidemiology of diaphragmatic rupture and to report our results in the diagnosis and treatment of this injury. METHODS: We present seven cases from 1999 through 2005. [pesquisa.bvsalud.org]
Daoud pp. 179–182 https://doi.org/10.5144/0256-4947.2008.179 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 [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]
Pathophysiology Currently, 80-90% of blunt diaphragmatic ruptures result from motor vehicle crashes (MVCs). Falls and other traumatic events rarely are implicated. [emedicine.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]
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]
The diaphragm also aids in emesis, urination, and prevention of gastroesophageal reflux. [ijri.org]