Massive haematemesis due to strangulated gangrenous gastric herniation as the delayed presentation of post-traumatic diaphragmatic rupture.
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. Patients present with non-specific symptoms and may complain of chest pain, abdominal pain, dyspnoea, tachypnoea and cough, heartburn and symptoms of gastro-oesophageal reflux. Respiratory distress and faeco-pneumothorax have been reported. We present an interesting case of traumatic diaphragmatic hernia presenting 5 years after a road traffic accident as acute abdomen and massive haematemesis due to strangulated gangrenous gastric hernia.
Department of Emergency Medicine, Hera General Hospital, Makkah, Saudi Arabia. dr_wani_majid@yahoo.co.in
Abdul Majid
AM
Wani
Turki
T
Al Qurashi
Saif Abdul
SA
Rehman
Zeyad S
ZS
Al Harbi
Abdul Rehman Y
AR
Sabbag
Mohd
M
Al Ahdal
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D000293:Adolescent; D057210:Delayed Diagnosis; D005500:Follow-Up Studies; D005734:Gangrene; D006396:Hematemesis / Q000175:diagnosis* / Q000209:etiology; D006547:Hernia / Q000000981:diagnostic imaging / Q000209:etiology*; D006549:Hernia, Diaphragmatic, Traumatic / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008297:Male; D018570:Risk Assessment; D013272:Stomach Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000175:diagnosis*