Delayed presentation of traumatic diaphragmatic hernia

McHugh, Kieran; Ogilvie, Bruce C.; Brunton, F.J.

doi:10.1016/s0009-9260(05)80247-8

Cited by 40 publications

(14 citation statements)

References 5 publications

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“…1 Regarding the length of delay, McHugh et al reported nine cases of delayed presentation of ruptured diaphragm, and the period of delay varied from 6 months to 16 years. 3 Divisi et al recommended VATS for the diagnosis of traumatic rupture of the diaphragm, especially in cases involving liver herniation into the thorax. 4 VATS may play a crucial role in the diagnosis of asymptomatic rupture of the diaphragm.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, the diagnosis is sometimes diffi cult and may be easily missed during the acute phase, 2 resulting in late presentation. 3 Because delayed traumatic rupture of the diaphragm may be identifi ed during an annual medical checkup, we believe that this report serves as a useful reminder of the importance of appropriate follow-up in patients with a history of blunt trauma.…”

Section: Introductionmentioning

confidence: 86%

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Delayed diagnosis of traumatic diaphragmatic rupture

Mizobuchi

Iwai

Kohno

et al. 2009

Gen Thorac Cardiovasc Surg

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We report a case of late presentation of traumatic rupture of the diaphragm discovered incidentally on chest radiography (CXR) during an annual medical checkup. A 60-year-old man suffered severe blunt trauma from heavy steel frames collapsing against his back, resulting in pelvic and femoral fractures as well as pulmonary contusions. The patient recovered, but 10 months later CXR performed for lung cancer surveillance during an annual medical checkup revealed a traumatic rupture of the diaphragm. Video-assisted thoracic surgery was performed with reduction of the intestine and primary closure of the diaphragmatic defect. The patient recovered uneventfully. This report serves as a useful reminder that a medical history of severe blunt trauma should provoke a high index of suspicion for diaphragmatic rupture during annual medical surveillance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 86%

Delayed diagnosis of traumatic diaphragmatic rupture

Mizobuchi

Iwai

Kohno

et al. 2009

Gen Thorac Cardiovasc Surg

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“…4 The clinical features are usually chronic symptoms such as upper abdominal and lower chest pain, nausea, dyspnea, and reflux after meals, 4 which may develop into an acute presentation with severe epigastric pain, vomiting, and intestinal obstruction. 9 Diaphragmatic injury is often missed in patients with polytrauma, with high mortality. 10 If the herniation is diagnosed, the operative mortality for correction of the defect is 10%.…”

Section: Discussionmentioning

confidence: 99%

Acute Intrathoracic Gastric Volvulus from a Diaphragmatic Hernia after Left Splenopancreatectomy: Report of a Case

et al. 2006

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Intrathoracic gastric volvulus is a rare event. It occurs when the stomach undergoes organoaxial torsion in the chest, caused either by concomitant enlargement of the hiatus or by a diaphragmatic hernia. A delay in diagnosis and treatment can result in fatal complications such as gastric ischemia, perforation, and hemorrhage. We report a case of intrathoracic localization of an acute and incarcerated organoaxial gastric volvulus caused by a left-sided diaphragmatic hernia resulting from a diaphragmatic injury. The patient had undergone a left splenopancreatectomy 4 years earlier for non-Hodgkin's lymphoma. We performed an emergency left thoracotomy with reduction of the acute volvulus, resection of the adhesions, and exeresis of an inflammatory mass from the omentum, with good results. The mechanisms of volvulus and diaphragmatic hernia with the relative diagnostic and therapeutic implications are discussed after this case report.

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“…The TDRs, which are rare clinical entities, are not detected in 90% of cases admitted to emergency departments after trauma [3]. A definitive diagnosis cannot be made after the first evaluation in more than half of cases and may be easily missed due to other more prominent symptoms related to other organ systems [4,5]. An asymptomatic clinical course can occur after isolated post-traumatic diaphragmatic ruptures, and the diagnosis is often established in a delayed manner after development of a herniation that leads to progressive symptoms.…”

Section: Introductionmentioning

confidence: 99%

Original article An extremely rare clinical condition: isolated post-traumatic diaphragmatic injuries

Taskesen¹,

Arıkanoğlu²,

Önder³

et al. 2012

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Aim: Isolated post-traumatic diaphragmatic injuries are observed less commonly, and the preoperative diagnosis is difficult to make. Material and methods: Thirteen patients with post-traumatic isolated diaphragmatic injury were treated in our department between January 2005 and June 2011. Age, sex, the cause, the location, the size of rupture, the severity of organ injury, the surgical materials used for repair, the associated morbidity and mortality, and the duration of hospitalization were all evaluated. Results: There were 12 male patients (92.3%) and 1 female patient (7.7%) with an overall mean age of 28.76 years (range: 15-55 years). Blunt trauma was responsible for the injuries in 4 patients (30.8%), while 9 patients (69.2%) had penetrating injuries. The diagnosis was established preoperatively in all patients (100%) via a plain chest X-ray and/or a computed tomography (CT) scan. The location of rupture was on the left side of the diaphragm in 12 patients (92.3%) and on the right side in 1 (7.7%). Isolated post-traumatic diaphragmatic rupture was repaired with interrupted nonabsorbable sutures or polypropylene mesh. Postoperative complications were observed in 2 patients (15.3%). Mortality did not occur in any of our patients. Conclusions: A meticulous physical examination and obtaining a chest X-ray should be the first steps to be taken in patients with suspicious isolated post-traumatic diaphragmatic rupture. In case of uncertainty in diagnosis, advanced modalities such as CT, ultrasonography, and magnetic resonance imaging should be utilized.

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Delayed presentation of traumatic diaphragmatic hernia

Cited by 40 publications

References 5 publications

Delayed diagnosis of traumatic diaphragmatic rupture

Delayed diagnosis of traumatic diaphragmatic rupture

Acute Intrathoracic Gastric Volvulus from a Diaphragmatic Hernia after Left Splenopancreatectomy: Report of a Case

Original article An extremely rare clinical condition: isolated post-traumatic diaphragmatic injuries

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