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[Traumatic diaphragmatic rupture with delayed unusual disclosure]
M Thicoïpé1, F Sztark, P Lassié
1Département des Urgences, Hôpital Pellegrin, Bordeaux.
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1995
Summary
Delayed traumatic diaphragmatic rupture is uncommon. A patient developed tension hydrothorax and stomach herniation nine months after minor thoracic trauma, presenting unusually after elective surgery.
Area of Science:
- Trauma surgery
- Thoracic surgery
- Surgical case reports
Background:
- Traumatic diaphragmatic rupture (TDR) often results from significant blunt force trauma.
- Delayed presentations of TDR are rare, typically occurring weeks to months post-injury.
- This case highlights a TDR presenting unusually late after a seemingly minor thoracic trauma.
Observation:
- A 22-year-old male experienced minor thoracic trauma from a road traffic accident.
- Nine months later, he underwent a minor surgical procedure under general anesthesia.
- Post-operatively, he developed tension hydrothorax due to stomach herniation and perforation into the left pleural cavity.
Findings:
- The patient's diaphragmatic rupture, sustained nine months prior, was diagnosed late.
- Herniation of abdominal contents (stomach) into the thoracic cavity caused acute respiratory distress.
- Intraoperative ventilatory factors during the subsequent surgery may have contributed to the hernia's manifestation.
Implications:
- This case underscores the importance of considering delayed TDR even after seemingly minor trauma.
- It highlights potential risks associated with general anesthesia and positive pressure ventilation in patients with undiagnosed diaphragmatic defects.
- Further investigation into the role of perioperative factors in precipitating delayed TDR is warranted.