Rupture of the liver and right hemidiaphragm presenting as right hemothorax.
A young man hit by a car while riding his motorcycle presented with reversible hypotension, a compression fracture of C6, fractures of the left femur and of ribs 9-12 on the right, and right hemothorax. A falsely negative peritoneal lavage delayed laparotomy, which, when done, demonstrated two right diaphragmatic rents with bleeding into the right chest from a severe liver injury. Presentation of this case demonstrates that while peritoneal lavage is an excellent way to exclude intraperitoneal hemorrhage following blunt abdominal trauma, false-negative results may occur in the setting of hemorrhage with diaphragmatic rupture.
Tribble
J B
JB
Department of Surgery, Bowman Gray School of Medicine of Wake Forest University Medical Center, Winston-Salem, North Carolina.
Julian
S
S
Myers
R T
RT
D000007:Abdominal Injuries / Q000175:diagnosis; D000063:Accidents, Traffic; D000328:Adult; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000293:injuries*; D006491:Hemothorax / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D011859:Radiography; D012421:Rupture; D014949:Wounds, Nonpenetrating / Q000175:diagnosis