DOI: http://dx.doi.org/10.18203/2349-2902.isj20221161

An isolated left diaphragmatic injury due to blunt trauma abdomen: a rare case entity

Preeti Juneja, Gautam Anand, Ashutosh Nagpal, Mangarai Mukund, Rahul Kumar, Sanjay Meena

Abstract


Isolated diaphragmatic injury in blunt trauma occurs acutely and can be associated with other life-threatening organ injuries. A sudden increase in abdominal pressure causes injury in the membranous or muscular part of the diaphragm. Isolated left diaphragmatic injury after blunt trauma is rarely seen, its diagnosis can be overlooked frequently. Early diagnosis is the most important step in the treatment thereby reducing morbidity and mortality. The most critical point during the diagnosis is the suspicion for clinical diaphragm injury like respiratory distress. Single or serial plain chest radiographs with a high index of suspicion are diagnostic in most cases. Computed tomography of the abdomen and thorax can be a guide for identifying the size of diaphragmatic injury and the contents. In this case report, we presented an isolated left side diaphragmatic rupture after blunt abdominal trauma and treated with an urgent surgical operation.


Keywords


Isolated left diaphragmatic injury, Blunt trauma, Emergency surgery, Diaphragm repair

Full Text:

PDF

References


Fair KA, Gordon NT, Barbosa RR, Rowell SE, Watters JM, Schreiber MA. Traumatic diaphragmatic injury in the American College of Surgeons National Trauma Data Bank: a new examination of a rare diagnosis. Am J Surg. 2015;209(5):864-8.

Matsevych OY. Blunt diaphragmatic rupture: four year's experience. Hernia. 2008;12(1):73-8.

Pace M, Vallati D, Belloni E, Cavallini M, Ibrahim M, Rendina EA, et al. Blunt Trauma Associated With Bilateral Diaphragmatic Rupture: A Case Report. Front Surg. 2021;8:772913.

Mousa W, Lapa C, Grossart C, Haq A. Delayed presentation of traumatic diaphragmatic rupture with tension colothorax and strangulation of the transverse colon. BMJ Case Rep. 2020;13(5):233336.

Kelley JK, Biesterveld BE, White PT, Vercruysee GA. Post-traumatic intercostal and diaphragm hernias following a sneezing episode. BMJ Case Rep. 2019;12(5):229250.

Baloyiannis I, Kouritas VK, Karagiannis K, Spyridakis M, Efthimiou M. Isolated right diaphragmatic rupture following blunt trauma. Gen Thorac Cardiovasc Surg. 2011;59(11):760-2.

Omer O, Ozkul F. Isolated left sided Diaphragmatic injury due to blunt trauma. Eur J Gen Med. 2014;11(3):197-9.

Testini M, Girardi A, Isernia RM, Palma A, Catalano G, Pezzolla A, et al. Emergency surgery due to diaphragmatic hernia: case series and review. World J Emerg Surg. 2017;12:23.