Diaphragmatic rupture due to violent cough during tracheostomy.
We present herein a rare case of diaphragmatic rupture due to violent coughing during tracheostomy. A 73-year-old man was admitted with cough, hoarseness and dysphagia caused by a huge laryngeal cancer obstructing the airways. Immediate emergency tracheostomy was performed, during which he experienced violent paroxysmal coughing, and he began to complain of right upper abdominal discomfort after tracheostomy. Chest radiography and computed tomography 4 days later showed right diaphragmatic rupture, through which small bowel loops had herniated into the right hemithorax. Diaphragmatic rupture with a 20-cm long fresh oblique tear was repaired through subsequent surgical treatment. Violent paroxysmal coughing during tracheostomy was considered likely to have caused this rare complication.
Department of Otolaryngology, Hamamatsu University School of Medicine, Handayama, and Hamamatsu Red Cross Hospital, Hamamatsu, Japan. hiro-na@hama-med.ac.jp
Hiroshi
H
Nakanishi
Satoshi
S
Iwasaki
Yasuhiro
Y
Ohkawa
Hideo
H
Nakazawa
Hiroyuki
H
Mineta
D000368:Aged; D003371:Cough / Q000150:complications*; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D013902:Radiography, Thoracic; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D014139:Tracheostomy / Q000379:methods*