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Diaphragmatic rupture

Case contributed by RMH Core Conditions
Diagnosis certain

Presentation

Motorbike accident. Hypotensive. Hypoxic.

Patient Data

Age: 45 years
Gender: Male
x-ray

The appearances of the nasogastric tube tip suggested that there may be rupture of the left hemidiaphragm with the stomach and other intra-abdominal contents now lying within the left hemithorax. There is mediastinal shift to the right. The exact position of the left hemidiaphragm is difficult to be certain of.

Multiple rib fractures are identified with extensive air space opacification noted. No definite pneumothorax can be identified.

Case Discussion

Patient proceeded to trauma laparotomy and diaphragmatic rupture was confirmed.

Diaphragmatic rupture is a rare consequence of blunt trauma but recognition is important as it carries significant mortality and morbidity. 

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