Late bilateral diaphragmatic rupture: challenging diagnostic and surgical repair

A 67-year-old man was referred to our department, after a vehicle accident, with multiple bone fractures and a left blunt diaphragmatic rupture. An emergency laparatomy was performed, and the left diaphragmatic defect directly sutured. Postoperatively, a delayed right diaphragmatic rupture occurred...

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Bibliographic Details
Published in:Hernia : the journal of hernias and abdominal wall surgery 2005-03, Vol.9 (1), p.90-92
Main Authors: Sirbu, H, Busch, T, Spillner, J, Schachtrupp, A, Autschbach, R
Format: Article
Language:English
Subjects:
Abdominal Injuries - complications
Abdominal Injuries - diagnosis
Abdominal Injuries - surgery
Accidents, Traffic
Aged
Diaphragm - diagnostic imaging
Diaphragm - injuries
Diaphragm - surgery
Follow-Up Studies
Fractures, Bone
Hernia, Diaphragmatic, Traumatic - diagnosis
Hernia, Diaphragmatic, Traumatic - etiology
Hernia, Diaphragmatic, Traumatic - surgery
Humans
Laparotomy
Male
Multiple Trauma
Radiography, Thoracic
Reconstructive Surgical Procedures - methods
Rupture
Suture Techniques
Thoracotomy
Tomography, X-Ray Computed
Ultrasonography
Wounds, Nonpenetrating - diagnosis
Wounds, Nonpenetrating - surgery
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Summary:A 67-year-old man was referred to our department, after a vehicle accident, with multiple bone fractures and a left blunt diaphragmatic rupture. An emergency laparatomy was performed, and the left diaphragmatic defect directly sutured. Postoperatively, a delayed right diaphragmatic rupture occurred due to progressive inflammation and muscle devitalisation. The diagnosis was challenging because the right rupture became clinically evident later after extubation. Diaphragmatic reconstruction was performed through a right thoracotomy. A high index of suspicion should always be observed for missed or delayed bilateral diaphragmatic ruptures.
ISSN:1265-4906
1248-9204
DOI:10.1007/s10029-004-0243-4