A Diaphragmatic Hernia and Pericardial Rupture Caused by Blunt Injury of the Chest: A Case Review

Abstract

Blunt traumatic diaphragmatic hernias are most commonly seen in combination with other injuries. Right diaphragmatic ruptures with serious pericardium ruptures are relatively rare. The diagnosis of diaphragmatic hernias is not difficult; however, prior to surgery, it is difficult to judge whether pericardium damage has occurred, particularly on the right side. This injury may occur in a critical pathological state in which cardiac tissue is outside the pericardium due to the pericardial defect. Severe hemodynamic disorders or even death may occur if the patient's condition is not diagnosed and treated in a timely manner. The transportation of patients with severe trauma must be performed with extreme caution. It is necessary to weigh a wide range of differential diagnoses in a serious and thorough initial investigation.

Late presentation of traumatic tricuspid valve chordal rupture and pericardial rupture with cardiac herniation: a case report

“…The rupture of the pericardium in blunt chest trauma is also very rare [ 13 ]. Deceleration forces are usually responsible for the occurrence of pericardial defect, since the base of the heart is more fixed to the pulmonary vasculature and aorta, while the apex is more mobile, causing the rupture mostly on the lateral side of pericardium [ 13 ].…”

“…The rupture of the pericardium in blunt chest trauma is also very rare [ 13 ]. Deceleration forces are usually responsible for the occurrence of pericardial defect, since the base of the heart is more fixed to the pulmonary vasculature and aorta, while the apex is more mobile, causing the rupture mostly on the lateral side of pericardium [ 13 ]. Pericardial rupture is seen in less than 0.5% of patients presenting after blunt trauma, and cardiac herniation through a pericardial defect is a potential complication of this injury [ 14 ].…”

Late presentation of traumatic tricuspid valve chordal rupture and pericardial rupture with cardiac herniation; a case report

“…The rupture of the pericardium in blunt chest trauma is also very rare [14]. It almost always leads to some degree of cardiac herniation through pericardial defect.…”

“…It almost always leads to some degree of cardiac herniation through pericardial defect. Deceleration forces are usually responsible for occurrence of pericardial defect, due to reason that base of the heart is more xed to the pulmonary vasculature and aorta, while apex of the heart is more mobile, causing the rupture mostly on the lateral site of pericardium during trauma [14]. The clinical ndings could vary from mild symptoms to the very severe, especially if the rupture causes the obstruction of huge blood vessels (pulmonary or coronary artery) [15].…”

Traumatic Diaphragmatic Rupture With Pericardial Tear and Transdiaphragmatic Herniation of the Stomach

“…One study reported that 40%, 25%, and 5% of patients had blunt diaphragmatic injuries with pelvic fracture, spleen and liver injuries, and thoracic aortic injuries, respectively [ 5 ]. Only a few cases of isolated rupture of the pericardium or combined diaphragmatic and pericardial ruptures have been reported [ 6 ]. Also, few cases of pericardial tear with intra-pericardial diaphragmatic hernia have been reported [ 7 ].…”