title: Diaphragmatic tear in pregnancy induced by intractable vomiting: a case report and review of the literature.
abstract: OBJECTIVE
  Nausea and vomiting of pregnancy, the most common medical condition of pregnancy, affects up to 80% of all pregnancies to some extent, and hyperemesis gravidarum does less than 1% of pregnant women. When hyperemesis gravidarum induces diaphragmatic tear, diagnosis can be missed because of nonspecific presentation with abdominal pain, nausea and vomiting.
  
  
  METHODS
  We reported a pregnant case suffering from intractable vomiting at the beginning of the second trimester (the 13th week of gestation) with delayed diagnosis of diaphragmatic tearing.
  
  
  RESULTS
  The patient was misdiagnosed initially, which delayed the surgical intervention and unnecessary abortion.
  
  
  CONCLUSIONS
  It is worthwhile considering the maternal diaphragmatic cause as an unusual one of refractory vomiting accompanied by clinically significant progressive epigastric pain, distension and respiratory embarrassment.
authors.affiliation: Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, Jiaotong University, Shanghai, China.
authors.forename: Xinliang
authors.initials: X
authors.lastname: Chen
authors.forename: Xiang
authors.initials: X
authors.lastname: Yang
authors.forename: Weiwei
authors.initials: W
authors.lastname: Cheng
mesh_terms: D000293:Adolescent; D003964:Diaphragm / Q000293:injuries* / Q000601:surgery; D005260:Female; D006549:Hernia, Diaphragmatic, Traumatic / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D009325:Nausea / Q000150:complications; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014839:Vomiting / Q000150:complications