• Journal of Trauma and Injury
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• v.31 no.1
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• pp.19-23
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• 2018

Traumatic diaphragmatic rupture is an unusual finding that may occur after blunt trauma. In addition, diaphragmatic rupture occurring bilaterally is extremely rare. We experienced a 6-year-old boy with bilateral diaphragmatic rupture, whom survived after surgical treatment by open thoracotomy but, complicated with spinal cord injury discovered after surgery.

• Journal of Chest Surgery
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• v.37 no.9
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• pp.813-816
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• 2004

The conformation of traumatic diaphragmatic rupture is frequently difficult, even if radiologic evaluation has been performed. A 37-year old man with multiple trauma was suspicious with diaphragmatic rupture. The diaphragmatic rupture could not be confirmed with chest CT. We decided thoracoscopic operation for diagnosis. Diaphragm was ruptured about 8 cm length involving entering site of phrenic none into diaphragm and diaphragmatic paralysis was combined. We made 5 cm sized working window additionally. Ruptured diaphragm was repaired by continuous suture and plication of diaphragm was performed. Postoperative result was good at chest radiogram after three monthes.

• Korean Journal of Veterinary Research
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• v.56 no.4
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• pp.265-267
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• 2016

A one-year-old female sika deer died suddenly with no preliminary signs during exhibition at a zoo. At necropsy, the carcass was emaciated and had dried fur. Examination of the thoracic cavity revealed a diaphragmatic rupture measuring 2 cm in diameter and a fracture in the middle of the right eighth rib. The liver and lungs had irregular circular discolorations caused by diaphragmatic rupture and subsequent herniation. Dark-brown-colored ascitic fluid, hydrothorax, and yellowish hydropericardium were also observed. The cause of death was determined to be diaphragmatic rupture caused by a rib fracture, which led to respiratory imbalance and circulatory disorders.

• Journal of Trauma and Injury
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• v.25 no.3
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• pp.87-90
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• 2012

Blunt diaphragmatic rupture (BDR) is a relatively rare injury and occurs in 0.8% to 7% of all thorocoabdominal blunt trauma. Especially right diaphragmatic rupture after blunt abdominal trauma is a rarer than left. The diagnosis of BDR can be missed while evaluating the multiple trauma patient. Other severe injuries may mask BDR during the primary resuscitation and survey. We experienced two cases of traumatic rupture of right diaphragm, one diagnosed immediately and the other diagnosed delayed. In this paper we present two cases of traumatic diaphragmatic rupture.

• Journal of Trauma and Injury
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• v.27 no.2
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• pp.38-42
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• 2014

Traumatic diaphragmatic rupture is quite uncommon and rarely lethal injury. However, delayed presentation between the injury and the diagnosis can cause a life-threatening condition with various complications such as intestinal hernia, obstruction, strangulation, respiratory distress. Here, we present a case of delayed presentation of traumatic diaphragmatic rupture in a 51-year-old man, and then discuss about the clinical implication of delayed presentation of diaphragmatic rupture with a review.

• Advances in pediatric surgery
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• v.6 no.1
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• pp.60-63
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• 2000

Spontaneous rupture of the eventrated diaphragm is not common. The authors report a case of spontaneous rupture of the congenital diaphragmatic eventration. An 8 year-old girl with right congenital diaphragmatic eventration and nephrotic syndrome was seen in emergency room because of severe abdominal pain and vomiting. She had intermittent abdominal pain for 1 year. Plain chest X-ray and ultrasonography showed entrapped bowels in the right thoracic area. Exploratory laparotomy revealed a ruptured right eventration. THE displaced abdominal viscera were repositioned into the abdominal cavity and the ruptured diaphragm was trimmed and plicated. The postoperative course was uneventful. Only one case of spontaneous rupture of eventrated diaphragmatic has been reported in the English literature.

• Investigative Magnetic Resonance Imaging
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• v.1 no.1
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• pp.154-161
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• 1997

Purpose: Traumatic rupture of the diaphragm is not easy to diagnose and often delayed. Delayed diagnosis of diaphragmatic rupture accompanied by higher chances of strangulation of herniated viscera which may result in higher morbility and mortality. The purpose of this study was to evaluate diagnostic accuracy of spiral CT, MRI and US for the diagnosis of diaphragmatic rupture in an animal model. Materials and Methods: Small, medium, and large sized transabdominal diaphragmatic ruptures were surgically made in experimental rabbits and then followed up with spiral CT, MR!, and US at 1 day, 3 day, and 1 week after operation. Results: US was superior to MR! or spiral CT in diagnosis of diaphragmatic rupture(P(0.05). The sensitivity and specificity were 94.4% and 92.9% for US, 54.0% and 85.7% for MRI, and 46.0% and 78.6% for spiral CT, respectively. The size of laceration was not related to diagnostic sensitivity in US. Sensitivity of MRI and spiral CT increased as the size of laceration were larger, but no statistical significance was present(P>0.05). All experimental animals developed pleural effusion or hemothorax one day after operation. In acute phase, US and MRI were more sensitive than spiral CT in detecting diaphragmatic rupture. Spiral CT was more sensitive than US and MRI in delayed phase but without statistical significance(P>0.05). In the experimental rabbits with accompanying visceral hernia through the diaphragmatic defect, diagnostic accuracy was found equally high among three image modalities(P>0.05). Conclusion: This study indicates that US is the most accurate diagnostic method in detecting injury to the diaphragm in a rabbit model. The findings obtained in this experimental study can be applied to the diaphragmatic rupture of human being.

• Journal of Chest Surgery
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• v.46 no.3
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• pp.230-233
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• 2013

While a diaphragmatic rupture commonly results from trauma to the abdomen and chest, a spontaneous diaphragmatic rupture is very rare. A 68-year-old male presented with chest pain that had originated while doing farm work in a squatting position. Images revealed a 5 cm defect of the left diaphragmatic dome, and the entire stomach was displaced into the thorax. The diaphragmatic defect was round and half had a well-demarcated margin. The remaining fragile tissue was completely excised and was closed primarily. The patient was uneventfully discharged and resumed with a normal diet 10 days after the operation.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.56-59
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• 2023

Traumatic diaphragmatic hernia is among the most uncommon conditions after severe trauma, and it is associated with high morbidity and mortality. The diagnosis is difficult and might be missed, but a multimodal investigation might help in terms of diagnostic yield. In this case report, we present a missed right diaphragmatic rupture 14 years after the trauma.

• Journal of Chest Surgery
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• v.7 no.2
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• pp.163-168
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• 1974

Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.