TRAUMATIC CHEST WALL INJURY WITH DIAPHRAGMATIC RUPTURE AND LUNG HERNIATION

TOPIC: Cardiothoracic Surgery TYPE: Medical Student/Resident Case Reports INTRODUCTION: Traumatic diaphragmatic injuries are a rare injury that can occur after chest wall trauma. Injury to the diaphragm and its surrounding structures easily be missed as patients often have polytrauma. We present case of penetrating with blunt traumatic rupture herniation left lung through motorcycle collision. CASE PRESENTATION: A 24-year-old male presented hospital trauma alert crash. The patient was found large open wound exposed diaphragm. He taken for CT imaging apical pneumothorax, contusion, rib fractures 2-10, grade 2 spleen laceration. emergent exploration his wound. disruption attachments lateral aspect at level 5-6. explored evidence inferior lobe lung. did not require any resection. entire examined central tendon intact, repaired along edge reattached costal cartilage laterally wall. washed out tube placed. remaining course uneventful, removed no signs air leaks. DISCUSSION: There specific or on physical exam. Missed result in major morbidity mortality patient. All should all time diagnosis. Most side right is protected by liver. highly recommend examine upper abdomen chest. In our which rare, we were able visualize When diagnosed early repair abdomen, but if late better approach. re-approximate CONCLUSIONS: tough diagnose times when there obvious noted full exposure surface examination organs rule further first examination. then laterally. Complete reattachment will allow avoid chronic could lead impaired respiratory function. REFERENCE #1: DeBarros, M., Martin, M.J. Penetrating Diaphragm Injuries. Curr Trauma Rep 1, 91-101 DISCLOSURES: No relevant relationships Michael Bishop, source=Web Response Alyssa Ritchie,