Traumatic Diafragmatic Rupture with Transthoracic Organs Herniation: A Rare Case Report

Abstract

Traumatic diaphragmatic rupture (TDR) is a serious condition seen with 3% - 8% estimated incidence at blunt abdominal traumatic events. A missed diagnosis may occur on computed tomography (CT) at a range of about 10% - 60%. There are a lot of diagnostic pitfalls like anatomical and congenital variants and acquired abnormalities in this condition. The patient with TDR that missed diagnosis can present with transthoracic organ herniation or strangulation. These complications have a mortality rate of 30% - 60%. The diagnosis of TDR on imaging is essential for early surgical repair of diaphragm injury. A 35-year-old man was brought to the emergency department by ambulance because of falling from high. The patient had multiple blunt traumas and a full body CT was obtained. The left hemi-diaphragmatic defect with intrathoracic herniation of the stomach and colon was seen on CT. Thereupon the patient was taken to the operation room urgently. The diaphragmatic hernia was repaired. No additional complications were observed in the patient. Our aim in this report is to raise awareness of these serious cases of blunt abdominal traumatic events.