Management of massive hemothorax resulting from traumatic diaphragm rupture with kidney avulsion injury by combined anterior thoracoabdominal approaches

Abstract

Abstract Blunt trauma resulting in diaphragm rupture, kidney avulsion injury, and subsequent hemothorax is rare and requires immediate surgical intervention. After diagnosis, urgent laparotomy with thoracotomy is needed to control renal bleeding. However, because of limitations in imaging studies, confirming this diagnosis is not straightforward, thus underscoring the importance of proper patient’s posturing. It is recommended that in cases of massive hemothorax combined with intra-abdominal bleeding, no matter performing thoracotomy or laparotomy first, the attending surgeons have to put patients in a position appropriate for simultaneous thoracoabdominal approach. It avoids surgical delays that could lead to fatal outcomes.