Skip to main content

Advertisement

Log in

A case of delayed diagnosis of a right-sided diaphragm rupture with a review of the literature

  • Case Report
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Right-sided diaphragm rupture is one of the typical injuries found during a secondary or tertiary survey after a major blunt trauma. This is mainly due to the apparently normal aspect of primary X-rays of the thorax. A right-sided diaphragm rupture can cause severe atelectasis of the right lower lobe of the lung, due to a hepatothorax. We present a case of a delayed diagnosis of right-sided diaphragm rupture, which was discovered by accident because of a new trauma. We review the literature on right-sided diaphragm rupture and its treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Igai H, Yokomise H, Kumagai K, Yamashita S, Kawakita K, Kuroda Y. Delayed hepatothorax due to right-sided traumatic diaphragmatic rupture. Gen Thorac Cardiovasc Surg 2007;55:434–436.

    Article  PubMed  Google Scholar 

  2. Schummer W, Schummer C, Hommann M, Schummer W. Delayed diagnosis of right-sided diaphragmatic rupture. Accid Emerg Nurs 2003;11:2–4.

    Article  PubMed  Google Scholar 

  3. Athanassiadi K, Kalavrouziotisi G, Athanassiou M, Vernikos P, Skrekas G, Poultsidi A, Bellenis I. Blunt diaphragmatic rupture. Eur J Cardiothorac Surg 1999;15:469–474.

    Article  CAS  PubMed  Google Scholar 

  4. Mansour KA. Trauma to the diaphragm. Chest Surg Clin N Am 1997;7:373–383.

    CAS  PubMed  Google Scholar 

  5. Reber PU, Schmied B, Seiler CA, Baer HU, Patel AG, Büchler MW. Missed diaphragmatic injuries and their long-term sequelae. J Trauma 1998;44:183–188.

    Article  CAS  PubMed  Google Scholar 

  6. Boulanger BR, Milzman DP, Rosati C, Rodriguez A. A comparison of right and left blunt traumatic diaphragmatic rupture. J Trauma 1993;35:255–260.

    Article  CAS  PubMed  Google Scholar 

  7. Shah R, Sabanathan S, Mearns AJ, Choudhury AK. Traumatic rupture of diaphragm. Ann Thorac Surg 1995;60:1444–1449.

    Article  CAS  PubMed  Google Scholar 

  8. Wirbel RJ, Mutschler W. Blunt rupture of the right hemi-diaphragm with complete dislocation of the right hepatic lobe: report of a case. Surg Today 1998;28:850–852.

    Article  CAS  PubMed  Google Scholar 

  9. Mihos P, Potaris K, Gakidis J, Paraskevopoulos J, Varvatsoulis P, Gougoutas B, Papadakis G, Lapidakis E. Traumatic rupture of the diaphragm: experience with 65 patients. Injury 2003;34:169–172.

    Article  PubMed  Google Scholar 

  10. Adegboye VO, Ladipo JK, Adebo OA, Brimmo AI. Diaphragmatic injuries. Afr J Med Med Sci 2002;31:149–153.

    CAS  PubMed  Google Scholar 

  11. Gelman R, Mirvis SE, Gens D. Diaphragmatic rupture due to blunt trauma: sensitivity of plain chest radiographs. AJR Am J Roentgenol 1991;156:51–57.

    CAS  PubMed  Google Scholar 

  12. Eren S, Kantarci M, Okur A. Imaging of diaphragmatic rupture after trauma. Clin Radiol 2006;61:467–477.

    Article  CAS  PubMed  Google Scholar 

  13. Mintz Y, Easter DW, Izhar U, Edden Y, Talamini MA, Rivkind AI. Minimally invasive procedures for diagnosis of traumatic right diaphragmatic tears: a method for correct diagnosis in selected patients. Am Surg 2007;73:388–392.

    PubMed  Google Scholar 

  14. Sangster G, Ventura VP, Carbo A, Gates T, Garayburu J, D'Agostino H. Diaphragmatic rupture: a frequently missed injury in blunt thoracoabdominal trauma patients. Emerg Radiol 2007;13:225–230.

    Article  CAS  PubMed  Google Scholar 

  15. Iochum S, Ludig T, Walter F, Sebbag H, Grosdidier G, Blum AG. Imaging of diaphragmatic injury: a diagnostic challenge? Radiographics 2002;22 Spec No:S103–S116; discussion S116-8.

    Google Scholar 

  16. Eren SF, Ciris F. Diaphragmatic hernia: diagnostic approaches with review of the literature. Eur J Radiol 2005;54:448–459.

    Article  PubMed  Google Scholar 

  17. Killeen KL, Mirvis SE, Shanmuganathan K. Helical CT of diaphragmatic rupture caused by blunt trauma. AJR Am J Roentgenol 1999;173:1611–1616.

    CAS  PubMed  Google Scholar 

  18. Scaglione M, Pinto F, Grassi R, Romano S, Giovine S, Sacco M, Forner AL, Romano L (2000) Diagnostic sensitivity of computerized tomography in closed trauma of the diaphragm. Retrospective study of 35 consecutive cases. Radiol Med (Torino) 99:46–50.

    CAS  Google Scholar 

  19. Nchimi A, Szapiro D, Ghaye B, Willems V, Khamis J, Haquet L, Noukoua C, Dondelinger RF. Helical CT of blunt diaphragmatic rupture. AJR Am J Roentgenol 2005;184:24–30.

    PubMed  Google Scholar 

  20. Murray JG, Caoili E, Gruden JF, Evans SJ, Halvorsen RA Jr, Mackersie RC. Acute rupture of the diaphragm due to blunt trauma: diagnostic sensitivity and specificity of CT. AJR Am J Roentgenol 1996;166:1035–1039.

    CAS  PubMed  Google Scholar 

  21. Patselas TN, Gallagher EG. The diagnostic dilemma of diaphragm injury. Am Surg 2002;68:633–639.

    PubMed  Google Scholar 

  22. Christie DB, Chapman J, Wynne JL, Ashley DW. Delayed rightsided diaphragmatic rupture and chronic herniation of unusual abdominal contents. J Am Coll Surg 2007;204:176.

    Article  PubMed  Google Scholar 

  23. Estrera AS, Landay MJ, McClelland RN. Blunt traumatic rupture of the right hemidiaphragm: experience in 12 patients. Ann Thorac Surg 1985;39:525–530.

    CAS  PubMed  Google Scholar 

  24. Lee WC, Chen RJ, Fang JF, Wang CC, Chen HY, Chen SC, Hwang TL, Jeng LB, Jan YY, Wang CS, et al. Rupture of the diaphragm after blunt trauma. Eur J Surg 1994;160:479–483.

    CAS  PubMed  Google Scholar 

  25. Epstein LI, Lempke RE. Rupture of the right hemidiaphragm due to blunt trauma. J Trauma 1968;8:19–28.

    Article  CAS  PubMed  Google Scholar 

  26. Haciibrahimoglu G, Solak O, Olcmen A, Bedirhan MA, Solmazer N, Gurses A. Management of traumatic diaphragmatic rupture. Surg Today 2004;34:111–114.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dagmar I. Vos MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Somford, M.P., Nuytinck, H.K.S. & Vos, D.I. A case of delayed diagnosis of a right-sided diaphragm rupture with a review of the literature. Eur J Trauma Emerg Surg 35, 499–502 (2009). https://doi.org/10.1007/s00068-008-8124-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-008-8124-7

Key Words

Navigation