Traumatic diaphragmatic rupture

Case contributed by Stephanie BM Tan
Diagnosis certain

Presentation

15 meter fall.

Patient Data

Age: 70 years
Gender: Male
x-ray

AP view of chest radiograph demonstrates a large gastric bubble in the left hemithorax. The nasogastric tube can be seen curling up within the fundus of the stomach.

When compared to the patient's old imaging, this is a new finding post 15 meter fall. This is consistent with a traumatic rupture of the left hemidiaphragm

Case Discussion

This patient was in respiratory distress and was taken to theater urgently for a laparotomy. At laparotomy, a 20 cm laceration in the left hemidiaphragm was identified. The fundus of the stomach and the spleen were reduced back into the abdominal cavity. The diaphragmatic tear was repaired primarily.

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