A rare case scenario: spontaneous diaphragmatic rupture during labor

Authors

  • Shambhu Nath Agrawal Department of General Surgery, Apollo Hospital, Bilaspur, Chhattisgarh, India
  • Amit Verma Department of General Surgery, Apollo Hospital, Bilaspur, Chhattisgarh, India
  • Sunil Kedia Department of General Surgery, Apollo Hospital, Bilaspur, Chhattisgarh, India
  • Amol Padegaonkar Department of General Surgery, Apollo Hospital, Bilaspur, Chhattisgarh, India
  • Hari Shankar Mahobia Department of General Surgery, All India Institute of Medical Science, Raipur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20212748

Keywords:

Spontaneous diaphragm rupture, Complication post-labor, Management of diaphragmatic rupture

Abstract

Diaphragmatic rupture during labor is not a very common presentation and usually occurs in patients with prior history of traumatic chest or abdominal injury or any congenital abnormality. We presented a case of a 29 year old woman who presented with sudden breathing difficulty two days after a full-term delivery by caesarean section. e-FAST scan suggested the presence of a massive pleural effusion over right side. CT scan of chest revealed large rent in right diaphragm with superior migration of liver and hepatic flexure. Patient was taken for emergent surgical intervention, inter coastal drainage (ICD) tube was placed and surgical repair was performed, patient was further treated in critical care unit, the patient recovered well and was discharged. Though diaphragmatic hernia rupture during labor are not reported often it is life threatening complication that requires immediate surgical intervention to prevent major complications and mortality.

References

Cameron J, Cameron A. Diaphragmatic injury. Current Surgical Therapy. Philadelphia, PA: Mosby-Elsevier; 2008: 975-87.

Graivier L, Freeark RJ. Traumatic diaphragmatic hernia. Archiv Surg. 1963;86(3):363-73.

Osman I, McKernan M, Rae DW. Normal vaginal delivery following rupture of the maternal diaphragm in pregnancy. J Obstet Gynaecol. 2007;27(6):625-7.

Hamoudi D, Bouderka MA, Benissa N, Harti A. Diaphragmatic rupture during labor. Int J Obstet Anesth. 2004;13(4):284-6.

Shah R, Sabanathan S, Mearns AJ, Choudhury AK. Traumatic rupture of diaphragm. Annal Thoracic Surg. 1995;60(5):1444-9.

Myers BF, McCabe CJ. Traumatic diaphragmatic hernia: occult marker of serious injury. Ann Surg. 1993;218(6):783-90.

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Published

2021-06-28

Issue

Section

Case Reports