Obstructed Traumatic Diaphragmatic Rupture Mimicking a Hydropneumothorax: Experience from a Low-resource Setting

Author:

Stephen Ezeanwu Achike1,Bolaji Akanni Abdulazeez1,Nelson Agagwuncha Onyebuchi1,Gold Ikponmwosa1,Callise Obi Chukwunyere1,Evantherese Nwosu1,Oluebube Okeke Chioma1,Stephen Nwafor Ogechukwu2,Vincent Okwulehie1

Affiliation:

1. Department of Surgery, National Cardiothoracic Centre of Excellence, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria

2. Department of Surgery, Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria

Abstract

Abstract Introduction: Obstructed diaphragmatic rupture, although rare, poses a rare and life-threatening risk and is challenging to diagnose due to its nonspecific symptoms. Timely recognition, early diagnosis, and appropriate management are crucial. Materials and Methods: We present a 15-year-old boy who arrived at the emergency with insidious onset of projectile, nonbilious vomiting, and left-sided chest pain with an antecedent history of trauma 10 months before presentation. Radiological assessment initially suggested a left-sided hydropneumothorax with a significant contralateral mediastinal shift. Clinical evaluation was suggestive of diaphragmatic rupture. Results: The patient underwent a left thoracotomy during which the herniated stomach, spleen, and omentum were reduced, and the diaphragmatic rupture was repaired. Conclusion: Following the procedure, the patient’s condition markedly improved, and he experienced a smooth recovery.

Publisher

Medknow

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