Spontaneous diaphragmatic rupture complicated with perforation of the stomach during Pilates

• Published in: The American journal of emergency medicine 2010-02, Vol.28 (2), p.259.e1-259.e3
• Main Authors: Yang, Young Mo, MD, Yang, Hee Bum, MD, Park, Jung Soo, MD, Kim, Hoon, MD, Lee, Suk Woo, MD, PhD, Kim, Jeong Hee, BA
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Pain - etiology; Adult; Computed tomography; Delayed Diagnosis; Diaphragm (Anatomy); Emergency; Emergency medical care; Emergency medical services; Exercise Movement Techniques - adverse effects; Female; Hernia, Diaphragmatic - diagnostic imaging; Hernia, Diaphragmatic - etiology; Humans; Leukocytes; Ostomy; Pain; Pilates; Pleural effusion; Pleural Effusion - diagnostic imaging; Pleural Effusion - etiology; Pneumothorax - diagnostic imaging; Pneumothorax - etiology; Radiography; Rupture, Spontaneous; Stomach; Stomach - injuries; Tomography; Trauma
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2009.06.012

Diaphragmatic rupture (DR) is most commonly seen after a blunt trauma. It rarely occurs spontaneously. Many cases of spontaneous DR followed by strenuous sports activity have been reported in the medical literature. However, there has been no previous report on a case of spontaneous DR after a static sport activity. We report the case of a 29-year old woman who presented to the emergency department (ED) with pain in the epigastric area that started 1 day before visiting the ED during deep breathing in Pilates. The radiography and computed tomography of her chest demonstrated a left diaphragmatic rupture complicated with the perforation of viscera. She immediately underwent left thoracotomy. In addition, primary repair of the diaphragm and stomach was performed. On the basis of our findings, we conclude that spontaneous DR may be caused by a static sport activity, such as Pilates, causing a serious life threatening condition.