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Diaphragmatic rupture

Case contributed by Mahomed A. Osman
Diagnosis certain

Presentation

Motor vehicle accident.

Patient Data

Gender: Female

Chest x-ray

x-ray

Poor inspiratory effort and rotated to the left. ETT in good position. Multiple rib fractures noted in the left 3rd, 4th, 5th, 6th and 7th ribs. Fracture of the infero-lateral aspect of the left scapula. Increased opacity of the left lung, more pronounced in the left lower zone, most likely indicating collapse with associated pleural effusion.

CT chest

ct

NG tube within the body of the stomach. ETT situated above the carina.Multiple left sided rib fractures noted. There is a large hematoma extending along the postero-lateral aspect of the left chest wall.

The left hemidiaphragm is ruptured, with herniation of the stomach and spleen into the left hemithorax. Associated left upper lobe collapse and moderate left hemothorax. There is a small right sided pleural effusion.

Case Discussion

Diaphragmatic injuries are more common on the left.

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