Strangulated Tension Viscerothorax with Gangrene of the Stomach in Missed
Traumatic Diaphragmatic Rupture

Onakpoya, Uvie Ufuoma; Ogunrombi, AB; Adenekan, Anthony Taiwo; Akerele, William

doi:10.5402/2011/458390

Cited by 13 publications

(13 citation statements)

References 14 publications

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“…Abdominal organ herniation due to diaphragmatic injury was first described by Sennertus in 1541 3 . They occur following motor vehicular accidents, falls and stabs or after upper abdominal surgeries 4 . It is found in up to 5% of patients with trauma 5 .…”

Section: Discussionmentioning

confidence: 99%

Acute Large Bowel Obstruction Following Late Sequelae of Traumatic Diaphragmatic Hernia

Hasan¹,

Baqui

Rahman

et al. 2020

J. Armed Forces Med. Coll.

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A 33 years old patient was admitted in a Military Hospital with the features of acute large gut obstruction. Exploratory laparotomy was done and peroperatively the obstruction was seen in the transverse colon and obstruction seemed to be carcinoma of transverse colon with involvement of left hemidiaphragm which was not negotiable. Transverse loop colostomy with decompression of bowel was done. Subsequently the patient was transferred to tertiary level hospital in Dhaka. In the tertiary hospital, the patient developed left sided massive pleural effusion. With relevant investigation the condition was diagnosed as left sided diaphragmatic hernia. Thoracotomy was done and herniorrhophy was performed after reduction of the content. Post-operative management was stormy and eventful but the condition improved gradually and the patient was discharged in proper time. The patient had history of chest trauma due to RTA he met 4 years back and he received hospital indoor management for 3½ months. The patient was asymptomatic and leading normal active military life before 2nd time admission for acute intestinal obstruction. The patient had past history of trauma to left chest wall 4 years back, presented with acute large gut obstruction and there was diagnostic dilemma. There were management difficulties and post operative events were stormy. The aim of this reporting is to highlight all of these. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 119-120

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Section: Discussionmentioning

confidence: 99%

Acute Large Bowel Obstruction Following Late Sequelae of Traumatic Diaphragmatic Hernia

Hasan¹,

Baqui

Rahman

et al. 2020

J. Armed Forces Med. Coll.

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“…On contrary suspition of a thoracoabdominal trauma may be considered as an important factor toward to a true diagnosis of occult diaphragmatic ruptures. Majority of the authors stress the importance of the delayed diagnosis in the developement of the life threatening complications, including fatal visceral strangulation with stomac necrosis [9], colopleural fistula with pneumothorax [10,11], tension fecopneumothorax [12][13][14][15]. Also this is an important factor for prevention of iatrogenic surgical events.…”

Section: Discussionmentioning

confidence: 99%

Risk Factores of Delayed Diaphragmatic Ruptures

Kotsis¹,

Kostic²,

Vadász³

2017

IJRRT

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In contrast to the world thoracic literature, less attention has been payed to blunt diaphragmatic ruptures in hungarian surgical literature.Based on 12 cases of blunt traumatic diaphragmatic rupture at Thoracic Surgical Clinic (1981-2001, circumstances of late recognition is evaluated. In majority of patients history of thoracic and/or abdominal truma has been totaly forgotten, resulting fals diagnosis of tension pneumothorax in one. In 3 others the diaphragmatic tear was missed during the previous laparotomy in one or considered as a hiatal hernia in the second and a really recurrent hernia was confused with a posttraumatic diaphragmatic palsy in the third. A subgroup of this entity, the two-steps ruture of one patient, may considered as a life-threatening urgency, when early approach is mandatory. In this series for diaphragmatic reconstruction in dominantly left-sided rutures (10) a similar sided postreolateral thoracotomy were used, and right-sided in the remaing 2, buttressed in only one, without mortality and recurrence.The delay of diagnosis may considered as the primordial factor of mortality. Even in long-lasting occult cases all efforts are necessary to solve the diagnostic dilemma, befor fatal visceral strangulation, befor development of feco-pneumothorax, gastric necrosis or tension pneumothorax. Suspition of the thoracoabdominal trauma may consisered as an important factor of true diagnosis and for pervention of iatrogenic surgical events. so transthoracic approach for diaphragmatic repair seems to be the best approach [16]. This series like other lage series reflects that delayed recognition of diaphragmatic rupture [17,18] may be considered as primordial factor of mortality. Keywords:

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“…A diaphragmatic hernia in this setting can be easily missed and detected late, as well as in cases in which there is clear history of trauma. 5 Evidently, elderly patients with a history of diaphragmatic eventration who are at risk of increased abdominal pressure and blunt trauma/falls may present with diaphragmatic hernias and ipsilateral lung collapse while exhibiting an acute abdomen picture. Therefore, any minor clues in history and physical examination can be crucial in raising suspicion for herniation, which can be confirmed by obtaining a plain chest film first.…”

Section: Discussionmentioning

confidence: 99%

Hemidiaphragmatic Hernia and Volvulus in a 94-Year-Old Woman

Charilaou

John

Yegneswaran

2017

The American Journal of Medicine

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Diaphragmatic hernias have been well documented in the medical literature, especially in the neonatal population. 1 Even though they can be corrected early during the neonatal period, it has been shown that they can carry forward an associated increase in late morbidity. 2 Diaphragmatic eventrations, on the other hand, are more likely to appear later in life and pose a risk for manifesting with gastrointestinal complications. 3 We present a rare case of a large left diaphragmatic hernia in an elderly patient, which led to total collapse of the left lung with an atypical presentation of no respiratory compromise.

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Strangulated Tension Viscerothorax with Gangrene of the Stomach in Missed Traumatic Diaphragmatic Rupture

Cited by 13 publications

References 14 publications

Acute Large Bowel Obstruction Following Late Sequelae of Traumatic Diaphragmatic Hernia

Acute Large Bowel Obstruction Following Late Sequelae of Traumatic Diaphragmatic Hernia

Risk Factores of Delayed Diaphragmatic Ruptures

Hemidiaphragmatic Hernia and Volvulus in a 94-Year-Old Woman

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