Traumatic diaphragmatic rupture

Case contributed by Sameh Saied Ali
Diagnosis certain

Presentation

Patient was a victim of major RTA with danger mechanism of injury. He was hemodynamically unstable.

Patient Data

Age: 40 years
Gender: Male
x-ray

Frontal chest radiograph shows markedly elevated left hemidiaphragm with undulant outline with elevation of the gastric shadow, associated with marked contralateral shift of the cardiac shadow and obliteration of the left costophrenic angle. 

Fracture of the left second rib. 

The patient was taken to the OT, where left diaphragmatic rupture and massive liver lacerations were found.

x-ray

Post-operative chest radiograph showing:

  • Restoration of the normal level of the left diaphragmatic copula.
  • Pneumopericardium/pneumomediastinum.
  • ICD tube with related left lateral chest wall surgical emphysema.  

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