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Right-sided diaphragmatic rupture after trauma-hepatothorax: a diagnostic challenge
Guruprasad Rai1, Rajkamal Vishnu1,2, Vijaya Kumara1
1Department of Cardiovascular Thoracic Surgery, Kasturba Hospital, Manipal Academy of Higher Education, Manipal, India.
Trauma Case Reports
|June 16, 2025
Summary
Right-sided traumatic diaphragmatic rupture is rare but should be considered in abdominal trauma cases. Prompt diagnosis with imaging and surgical repair are crucial for successful patient outcomes.
Area of Science:
- Trauma surgery
- Thoracic surgery
- Diagnostic imaging
Background:
- Traumatic diaphragmatic rupture is an uncommon injury.
- Right-sided ruptures are less frequent than left-sided due to the liver's protective effect.
- This report details two rare cases of right-sided diaphragmatic rupture with liver herniation.
Observation:
- Two male patients (64 and 56 years old) sustained blunt trauma.
- Case 1: Motorcycle accident resulted in hemothorax and elevated diaphragm.
- Case 2: Road traffic accident caused pneumoperitoneum, rib fractures, and liver herniation.
Findings:
- Both cases involved right-sided diaphragmatic rupture with liver herniation into the thorax.
- Imaging confirmed hemothorax, pneumoperitoneum, and elevated diaphragm.
- Surgical repair was successfully performed in both patients.
Implications:
- Right-sided diaphragmatic rupture requires consideration in abdominal trauma, even with subtle presentations.
- Diagnostic imaging, including chest X-ray and CT scans, is vital.
- Surgical intervention is the standard treatment for diaphragmatic defects.
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