Presentation
Trauma. Post traumatic pneumatocele?
Patient Data
Age: 30 years
Gender: Female
AP
Large left pleural effusion with mediastinal shift to the right. Gastric bubble in the left hemithorax.
The right lung and pleural space are clear. No displaced rib fractures.
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Sagittal C+ arterial phase
Abdominal viscera lie with the left hemithorax in keeping with a ruptured diaphragm.
Case Discussion
The CT findings are in keeping with rupture of the left hemidiaphragm, confirmed and repaired at surgery.
Diaphragmatic rupture often results from blunt abdominal trauma, which is usually associated with motor-vehicle accidents and hence a predominance of young males.
In major trauma, if the diaphragm cannot be identified one should have a high index of suspicion for possible rupture of the hemidiaphragm.
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