Diaphragmatc Rupture With Lef Colon and Spleen Herniaton and Small Intestne Injury Afer Blunt Trauma
Abstract
Traumatic Diaphragmatic Rupture (TDR) is a rare type of trauma. Small intestine injuries are the third most common type of injury resulting from blunt trauma to abdominal organs. The immediate diagnosis of TDR and bowel injuries is a daunting task. We reported a 53-year-old male patient who was transferred to the hospital by EMS because of a car accident. The chest X-ray showed the left diaphragm elevation. Also, a computed tomography scan revealed that the greater omentum, a portion of the colon, spleen, and stomach were transposed in the hemithorax through a diaphragm rupture. The patient underwent laparotomy and the incidental findings in laparotomy showed bowel injuries. This case was a common cause of traumatic left-sided diaphragmatic rupture and intestinal injury. The suspicion of diaphragmatic rupture and intestinal injury in a patient with multiple traumas contributes to early diagnosis. Surgical repair remains the only treatment for diaphragmatic rupture. The severe injury in a part of the intestine may result in the resection of that part.
[2] Athanassiadi K, Kalavrouziots G, Athanassiou M, Vernikos P, Skrekas G, Poultsidi A, et al. Blunt diaphragmatc rupture. European Journal of Cardio-Thoracic Surgery. 1999; 15(4):469-74. [DOI:10.1016/S1010-7940(99)00073-1]
[3] Lopez PP, Arango J, Gallup TM, Cohn SM, Myers J, Corneille M, et al. Diaphragmatc injuries: What has changed over a 20-year period? The American Surgeon. 2010; 76(5):512-6. [DOI:10.1177/00 0313481007600520] [PMID]
[4] Gao JM, Gao YH, Zeng JB, Wang JB, He P, Wei GB, et al. Polytrauma with thoracic and/or abdominal injuries: Experience in 1540 cases. Chinese Journal of Traumatology. 2006; 9(2):108-14. [PMID]
[5] Cruz CJ, Minagi H. Large-bowel obstructon resultng from traumatic diaphragmatc hernia: Imaging fndings in four cases. AJR. American Journal of Roentgenology. 1994; 162(4):843-5. [DOI:10.2214/ ajr.162.4.8141004] [PMID]
[6] Eren S, Kantarci M, Okur A. Imaging of diaphragmatc rupture after trauma. Clinical Radiology. 2006; 61(6):467-77. [DOI:10.2214/ ajr.162.4.8141004]
[7] James R, Gilbert J, Byard RW. Postraumatc diaphragmatc herniaand death--etologic factor or putrefactve artfact? The American Journal of Forensic Medicine and Pathology. 1999; 20(1):66-9. [DOI:10.1097/00000433-199903000-00016] [PMID]
[8] Shah R, Sabanathan S, Mearns AJ, Choudhury AK. Traumatc rupture of diaphragm. The Annals of Thoracic Surgery. 1995; 60(5):1444-9. [DOI:10.1097/00000433-199903000-00016]
[9] Kearney PA, Rouhana SW, Burney RE. Blunt rupture of the diaphragm: Mechanism, diagnosis, and treatment. Annals of Emergency Medicine. 1989; 18(12):1326-30. [DOI:10.1097/00000433- 199903000-00016]
[10] Sangster G, Ventura VP, Carbo A, Gates T, Garayburu J, D'Agostno H. Diaphragmatc rupture: A frequently missed injury in blunt thoracoabdominal trauma patents. Emergency Radiology. 2007; 13(5):225-30. [DOI:10.1007/s10140-006-0548-y] [PMID]
[11] Munns J, Richardson M, Hewet P. A review of intestnal injury from blunt abdominal trauma. The Australian and New Zealand Journal of Surgery. 1995; 65(12):857-60. [DOI:10.1111/j.1445-2197.1995. tb00576.x] [PMID]
[12] Zheng YX, Chen L, Tao SF, Song P, Xu SM. Diagnosis and management of colonic injuries following blunt trauma. World Journal of Gastroenterology. 2007; 13(4):633-6. [DOI:10.3748/wjg.v13.i4.633] [PMID] [PMCID]
[13] Mukhopadhyay M. Intestnal injury from blunt abdominal trauma: A study of 47 cases. Oman Medical Journal. 2009; 24(4):256-9. [DOI:10.5001/omj.2009.52] [PMID] [PMCID]
Files | ||
Issue | Vol 6 No 3 (2021): May-June | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/crcp.v6i3.7122 | |
Keywords | ||
Diaphragmatc hernia Small intestne Blunt trauma |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |