title: A case of a diaphragmatic rupture complicated with lacerations of stomach and spleen caused by a violent cough presenting with mediastinal shift.
abstract: BACKGROUND
  Diapraghmatic rupture is a clinical case that is mostly seen following a blunt thoracoabdominal trauma or is rarely reported as spontaneously induced by various factors.
  
  
  METHODS
  A 28-year-old man presented as an emergency with shortness of breath and severe abdominal pain following a violent cough. His chest radiography and computed tomography demonstrated left diaphragmatic rupture, mediastinal shift and herniation of gastric fundus into the pleural cavity.
  
  
  METHODS
  Left thoracotomy for the replacement of herniated gastric fundus and median laparotomy for the repair of serosal layer of gastric fundus and a diaphragmatic gap were performed.
  
  
  RESULTS
  He made an uneventful recovery.
  
  
  CONCLUSIONS
  Diaphragmatic ruptures may be caused by violent coughing with serious life-threatening complications.
authors.affiliation: Department of General Surgery, School of Medicine, University of Celal Bayar, Manisa, Turkey. eraykara@hotmail.com
authors.forename: E
authors.initials: E
authors.lastname: Kara
authors.forename: Y
authors.initials: Y
authors.lastname: Kaya
authors.forename: R
authors.initials: R
authors.lastname: Zeybek
authors.forename: T
authors.initials: T
authors.lastname: Coskun
authors.forename: C
authors.initials: C
authors.lastname: Yavuz
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000601:surgery; D000328:Adult; D003131:Combined Modality Therapy; D003371:Cough / Q000150:complications*; D016638:Critical Illness; D004417:Dyspnea; D004636:Emergency Service, Hospital; D005500:Follow-Up Studies; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D022125:Lacerations; D007813:Laparotomy / Q000379:methods; D008297:Male; D008477:Mediastinal Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D013902:Radiography, Thoracic; D018570:Risk Assessment; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery; D012720:Severity of Illness Index; D013154:Spleen / Q000503:physiopathology / Q000601:surgery; D013270:Stomach / Q000503:physiopathology / Q000601:surgery*; D013908:Thoracotomy / Q000379:methods; D014057:Tomography, X-Ray Computed