title: Pregnancy complicated by traumatic diaphragmatic rupture. A case report.
abstract: BACKGROUND
  Diaphragmatic rupture may be easily overlooked at the time of multiple trauma. Occult diaphragmatic rupture may first manifest during pregnancy as severe dyspnea.
  
  
  METHODS
  A parous woman who had sustained multiple traumatic injuries prior to pregnancy presented in midtrimester with abdominal pain and dyspnea. Chest roentgenography and computed tomography revealed bowel in the left hemithorax, compatible with a left-sided diaphragmatic rupture. Surgical correction was indicated secondary to the symptomatic nature of the presentation.
  
  
  CONCLUSIONS
  Diaphragmatic rupture may be occult and may first present during a subsequent pregnancy. Surgical therapy is the cornerstone of management when a diaphragmatic defect is symptomatic. The route of delivery may be individualized for patients with diaphragmatic repairs in whom there has been sufficient time for healing.
authors.affiliation: Department of Obstetrics and Gynecology, Wright State University School of Medicine, Dayton, Ohio, USA.
authors.forename: R P
authors.initials: RP
authors.lastname: Flick
authors.forename: J A
authors.initials: JA
authors.lastname: Bofill
authors.forename: J C
authors.initials: JC
authors.lastname: King
mesh_terms: D000293:Adolescent; D003964:Diaphragm / Q000293:injuries*; D005260:Female; D006549:Hernia, Diaphragmatic, Traumatic / Q000601:surgery*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D012421:Rupture