Nigerian Journal of Medicine (Jun 2024)

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

  • Ezeanwu Achike Stephen,
  • Akanni Abdulazeez Bolaji,
  • Agagwuncha Onyebuchi Nelson,
  • Ikponmwosa Gold,
  • Obi Chukwunyere Callise,
  • Nwosu Evantherese,
  • Okeke Chioma Oluebube,
  • Nwafor Ogechukwu Stephen,
  • Okwulehie Vincent

DOI
https://doi.org/10.4103/NJM.NJM_121_23
Journal volume & issue
Vol. 32, no. 5
pp. 559 – 563

Abstract

Read online

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.

Keywords