Hepatic coma resulting from diaphragmatic rupture and hepatic herniation.
We treated a unique case of blunt rupture of the right hemidiaphragm that produced acute hepatic failure with jaundice and coma. Laparotomy showed total eventration of the liver into the chest. The hepatic failure was caused by strangulation of the extrahepatic biliary and venous structures. Surgical repair was followed by recovery and normalization of hepatic function. This case stresses the need to diagnose and treat diaphragmatic ruptures promptly to prevent such threatening complications. The diagnosis of right diaphragmatic rupture must be suspected in instances of blunt injury, with an awareness of misleading presentations.
D003964:Diaphragm / Q000293:injuries*; D006501:Hepatic Encephalopathy / Q000209:etiology*; D006547:Hernia / Q000209:etiology; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008107:Liver Diseases / Q000150:complications / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D012421:Rupture; D014949:Wounds, Nonpenetrating / Q000150:complications*