A case of a diaphragmatic rupture complicated with lacerations of stomach and spleen caused by a violent cough presenting with mediastinal shift

Ann Acad Med Singap. 2004 Sep;33(5):649-50.

Abstract

Introduction: Diapraghmatic rupture is a clinical case that is mostly seen following a blunt thoracoabdominal trauma or is rarely reported as spontaneously induced by various factors.

Clinical picture: A 28-year-old man presented as an emergency with shortness of breath and severe abdominal pain following a violent cough. His chest radiography and computed tomography demonstrated left diaphragmatic rupture, mediastinal shift and herniation of gastric fundus into the pleural cavity.

Treatment: Left thoracotomy for the replacement of herniated gastric fundus and median laparotomy for the repair of serosal layer of gastric fundus and a diaphragmatic gap were performed.

Outcome: He made an uneventful recovery.

Conclusions: Diaphragmatic ruptures may be caused by violent coughing with serious life-threatening complications.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnosis
  • Abdominal Pain / surgery
  • Adult
  • Combined Modality Therapy
  • Cough / complications*
  • Critical Illness
  • Dyspnea
  • Emergency Service, Hospital
  • Follow-Up Studies
  • Hernia, Diaphragmatic / diagnostic imaging*
  • Hernia, Diaphragmatic / surgery*
  • Humans
  • Lacerations
  • Laparotomy / methods
  • Male
  • Mediastinal Diseases / diagnostic imaging
  • Mediastinal Diseases / surgery
  • Radiography, Thoracic
  • Risk Assessment
  • Rupture, Spontaneous / diagnostic imaging
  • Rupture, Spontaneous / surgery
  • Severity of Illness Index
  • Spleen / physiopathology
  • Spleen / surgery
  • Stomach / physiopathology
  • Stomach / surgery*
  • Thoracotomy / methods
  • Tomography, X-Ray Computed