title: A review on delayed presentation of diaphragmatic rupture.
abstract: Diaphragmatic rupture is a life-threatening condition. Diaphragmatic injuries are quite uncommon and often result from either blunt or penetrating trauma. Diaphragmatic ruptures are usually associated with abdominal trauma however, it can occur in isolation. Acute traumatic rupture of the diaphragm may go unnoticed and there is often a delay between the injury and the diagnosis. A comprehensive literature search was performed using the terms "delayed presentation of post traumatic diaphragmatic rupture" and "delayed diaphragmatic rupture". The diagnostic and management challenges encountered are discussed, together with strategies for dealing with them. We have focussed on mechanism of injury, duration, presentation and site of injury, visceral herniation, investigations and different approaches for repair. We intend to stress on the importance of delay in presentation of diaphragmatic rupture and to provide a review on the available investigations and treatment methods. The enclosed case report also emphasizes on the delayed presentation, diagnostic challenges and the advantages of laparoscopic repair of delayed diaphragmatic rupture.
authors.affiliation: Division of GI Surgery, University of Nottingham, Graduate Entry Medical School, Uttoxeter Road, Derby, DE22 3DT, UK. farhan_rashid@hotmail.com.
authors.forename: Farhan
authors.initials: F
authors.lastname: Rashid
authors.forename: Mallicka M
authors.initials: MM
authors.lastname: Chakrabarty
authors.forename: Rajeev
authors.initials: R
authors.lastname: Singh
authors.forename: Syed Y
authors.initials: SY
authors.lastname: Iftikhar
references.citation: Ann Surg. 1993 Dec;218(6):783-90
references.pmid: 8257229
references.citation: Am Surg. 2007 Apr;73(4):388-92
references.pmid: 17439035
references.citation: Indian J Chest Dis Allied Sci. 2002 Apr-Jun;44(2):121-4
references.pmid: 12026251
references.citation: World J Emerg Surg. 2008 Dec 04;3:33
references.pmid: 19055805
references.citation: AJR Am J Roentgenol. 2001 Nov;177(5):1137-40
references.pmid: 11641188
references.citation: CJEM. 2004 Jul;6(4):277-80
references.pmid: 17382006
references.citation: World J Emerg Surg. 2006 Aug 31;1:24
references.pmid: 16945124
references.citation: World J Emerg Surg. 2006 Oct 19;1(1):31
references.pmid: 17052332
references.citation: AJR Am J Roentgenol. 1991 Jan;156(1):51-7
references.pmid: 1898570
references.citation: Ugeskr Laeger. 2008 Apr 28;170(18):1571
references.pmid: 18454931
references.citation: Am J Emerg Med. 2008 Feb;26(2):252.e3-4
references.pmid: 18272132
references.citation: Rev Gastroenterol Peru. 2008 Jul-Sep;28(3):244-7
references.pmid: 18958140
references.citation: Anesth Analg. 1994 Jun;78(6):1187-9
references.pmid: 8198282
references.citation: Chir Ital. 2005 Mar-Apr;57(2):243-6
references.pmid: 15916154
references.citation: Rev Pneumol Clin. 2009 Feb;65(1):23-6
references.pmid: 19306780
references.citation: J Laparoendosc Adv Surg Tech A. 2000 Apr;10(2):111-4
references.pmid: 10794216
references.citation: G Chir. 1998 May;19(5):235-8
references.pmid: 9677778
references.citation: Anesth Analg. 2007 Jan;104(1):224-5
references.pmid: 17179293
references.citation: J Trauma. 2000 Jul;49(1):156-9
references.pmid: 10912874
references.citation: Am Surg. 1999 Aug;65(8):761-5
references.pmid: 10432087
references.citation: Injury. 1998 Jul;29(6):479-80
references.pmid: 9813710
references.citation: World J Emerg Surg. 2008 Jul 12;3:20
references.pmid: 18620592
references.citation: Arch Surg. 1988 Jul;123(7):828-32
references.pmid: 3382348
references.citation: Hernia. 2005 Mar;9(1):90-2
references.pmid: 15351874
references.citation: Hernia. 2007 Jun;11(3):257-9
references.pmid: 17186114
references.citation: AJR Am J Roentgenol. 2005 Jan;184(1):24-30
references.pmid: 15615945
references.citation: Surg Endosc. 2001 Mar;15(3):323
references.pmid: 11344439
references.citation: Am J Surg. 1974 Aug;128(2):175-81
references.pmid: 4843862
references.citation: Ann Thorac Surg. 1995 Nov;60(5):1444-9
references.pmid: 8526655
references.citation: Am Surg. 2007 Sep;73(9):845-50
references.pmid: 17939410
references.citation: Ann Surg. 1994 Feb;219(2):144-56
references.pmid: 8129485
references.citation: Am Fam Physician. 1992 Aug;46(2):453-6
references.pmid: 1636561
references.citation: BMC Gastroenterol. 2006 Nov 28;6:38
references.pmid: 17132174
references.citation: J Trauma. 1994 Mar;36(3):424-7
references.pmid: 8145332
references.citation: Surg Endosc. 1998 Nov;12(11):1358-60
references.pmid: 9788863
references.citation: Minerva Chir. 2008 Oct;63(5):425-7
references.pmid: 18923354
references.citation: J Emerg Med. 2010 Jul;39(1):21-4
references.pmid: 18486412
references.citation: Biomaterials. 2001 Oct;22(19):2653-9
references.pmid: 11519785
references.citation: Emerg Med J. 2006 Oct;23(10):e54
references.pmid: 16988292
references.citation: Ulus Travma Acil Cerrahi Derg. 2006 Jan;12(1):68-70
references.pmid: 16456753
references.citation: Gen Thorac Cardiovasc Surg. 2007 Oct;55(10):434-6
references.pmid: 18018610
references.citation: Surg Endosc. 2003 Apr;17(4):660
references.pmid: 12574936
references.citation: Injury. 2001 Mar;32(2):153-6
references.pmid: 11223047
references.citation: Minerva Chir. 1994 May;49(5):481-7
references.pmid: 7970049
references.citation: J Trauma. 1996 Jun;40(6):1047
references.pmid: 8656464
references.citation: Prim Care Respir J. 2007 Feb;16(1):54-6
references.pmid: 17097345
references.citation: Emerg Radiol. 2007 Feb;13(5):225-30
references.pmid: 17136377
references.citation: Am J Surg. 1995 Jul;170(1):5-9
references.pmid: 7793494
references.citation: J Trauma. 2003 Jul;55(1):180
references.pmid: 12855902
references.citation: J Chir (Paris). 1990 Jan;127(1):6-12
references.pmid: 2179244
references.citation: Ann Saudi Med. 1999 Mar-Apr;19(2):137-8
references.pmid: 17337954
references.citation: J Okla State Med Assoc. 2003 Apr;96(4):181-3
references.pmid: 12733206
references.citation: J Trauma. 1973 Nov;13(11):946-50
references.pmid: 4749516
references.citation: J Am Coll Surg. 2007 Jan;204(1):176
references.pmid: 17189127