CASE REPORT

Misdiagnosis of diaphragmatic rupture in a trauma setting

A L C Jones^I; I Thirsk^II

^IBMedSci, BM BS, MRCS; Ngwelezana Hospital, KwaZulu-Natal
^IIMB BS, FCS (SA); Ngwelezana Hospital, KwaZulu-Natal

ABSTRACT

Distinguishing diaphragmatic eventration from rupture in the trauma setting can be a considerable challenge. We present a case involving a man suffering from chest pain and with a raised left hemidiaphragm on the chest radiograph after a motor vehicle injury. A review of the literature discusses the use of imaging modalities and subsequent surgical diagnostic procedures in the face of uncertainty.

“Full text available only in PDF format”

REFERENCES

1. Maish MS. The diaphragm. Surg Clin North Am 2010;90(5):955-968.         [ Links ]

2. Sandstrom CK, Stern EJ. Diaphragmatic hernias: a spectrum of radiographic appearances. Curr Probl Diagn Radiol 2011;40(3):95-115.         [ Links ]

3. McGillicuddy D, Rosen P. Diagnostic dilemmas and current controversies in blunt chest trauma. Emerg Med Clin North Am 2007;25(3):695-711, viii-ix.         [ Links ]

4. Khan A. Imaging in Diaphragm Injury and Paresis. Medscape. http://emedicine.medscape.com/article/355284-overview (accessed 2 August 2011).         [ Links ]

5. Ouazzani A, Guerin E, Capelluto E, et al. A laparoscopic approach to left diaphragmatic rupture after blunt trauma. Acta Chir Belg 2009;109(2):228-231.         [ Links ]

6. Lin HF, Wu JM, Tu CC, Chen HA, Shih HC. Value of diagnostic and therapeutic laparoscopy for abdominal stab wounds. World J Surg 2010;34(7):1653-1662.         [ Links ]

7. Morgan BS, Watcyn-Jones T, Garner JP. Traumatic diaphragmatic injury. J R Army Med Corps 2010;156(3):139-149.         [ Links ]

8. Groth SS, Andrade RS. Diaphragm plication for eventration or paralysis: A review of the literature. Ann Thorac Surg 2010;89(6):S2146-S2150.         [ Links ]