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Liver in the Chest: A Case of a Large Traumatic Diaphragmatic Rupture
Rebecca Innes1, Mohan Kulkarni2
1Surgery, Henry Ford Health System, Jackson, USA.
Cureus
|September 15, 2021
Summary
Motor vehicle collisions can cause severe diaphragmatic rupture. A case study shows successful repair of a large liver herniation due to blunt diaphragmatic rupture from a car crash.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Surgical Case Reports
Background:
- Motor vehicle collisions (MVCs) are a leading cause of traumatic injuries globally.
- Blunt diaphragmatic rupture (BDR) is a severe consequence of high-impact trauma, often associated with multiple injuries.
- Diagnosis of BDR typically occurs during the secondary survey in trauma care.
Observation:
- A patient involved in an MVC presented with multiple injuries.
- Initial trauma assessment and treatment did not immediately identify a significant right-sided diaphragmatic injury.
- Persistent right hemidiaphragm elevation was noted on imaging.
Findings:
- Intraoperative findings revealed a Grade IV, 30 cm right-sided diaphragmatic rupture.
- Complete herniation of the liver into the chest cavity was observed.
- The liver was successfully repositioned, and the diaphragm was repaired primarily without complications.
Implications:
- This case highlights the potential for delayed diagnosis of severe diaphragmatic injuries in blunt MVCs.
- It underscores the importance of thorough evaluation even when other severe injuries are present.
- Demonstrates the feasibility of successful surgical repair and rapid recovery for significant blunt diaphragmatic rupture.
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