Delayed diagnosis of traumatic diaphragmatic rupture.
We report a case of late presentation of traumatic rupture of the diaphragm discovered incidentally on chest radiography (CXR) during an annual medical checkup. A 60-year-old man suffered severe blunt trauma from heavy steel frames collapsing against his back, resulting in pelvic and femoral fractures as well as pulmonary contusions. The patient recovered, but 10 months later CXR performed for lung cancer surveillance during an annual medical checkup revealed a traumatic rupture of the diaphragm. Video-assisted thoracic surgery was performed with reduction of the intestine and primary closure of the diaphragmatic defect. The patient recovered uneventfully. This report serves as a useful reminder that a medical history of severe blunt trauma should provoke a high index of suspicion for diaphragmatic rupture during annual medical surveillance.
Department of Chest Surgery, Matsudo City Hospital, 4005 Kamihongo, Matsudo-shi, Chiba, 271-8511, Japan. tmizobuchi@hotmail.com
Teruaki
T
Mizobuchi
Naomichi
N
Iwai
Hiromasa
H
Kohno
Nao
N
Okada
Tomoki
T
Yoshioka
Hiroki
H
Ebana
D057210:Delayed Diagnosis; D006549:Hernia, Diaphragmatic, Traumatic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D013536:Suture Techniques; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery