An Unusual Presentation of Diaphragmatic Rupture

Representing less than 1% of all traumatic injuries, diaphragmatic injuries are uncommon and are usually associated with injuries in other thoracic and abdominal organs. We report a case of a diaphragmatic injury in a 38-year-old man who presented to the Emergency Department due to a pedestrian-vehicle accident. He had a massive hemothorax on the left due to a ruptured spleen. An exploratory laparotomy was done to manage the bleeding, restore the diaphragmatic hernia contents in their right anatomical position, conduct a splenectomy, and repair the diaphragmatic defect. Although the majority of diaphragmatic ruptures are diagnosed acutely, late presentations are usually reported in blunt trauma; therefore, a high clinical suspicion with imaging is essential for the diagnosis.