Minimally Invasive Treatment of Traumatic Diaphragm Rupture.

Abstract

Background: Diaphragmatic rupture is a rare but potentially life-threatening injury that can result from blunt or penetrating trauma. Timely diagnosis is critical to prevent serious complications, yet clinical and radiological assessments are often inconclusive.

Case presentation: We report the case of a 39-year-old male patient who sustained blunt thoracoabdominal trauma in a motor vehicle accident. The patient presented with respiratory distress and generalized abdominal tenderness. Imaging revealed a left diaphragmatic defect with herniation of abdominal organs into the thoracic cavity.

Surgical technique: The patient underwent diagnostic laparoscopy, which confirmed an 8 × 5 cm defect in the left diaphragmatic dome with herniation of the stomach and omentum. The herniated organs were reduced, and the defect was repaired tension-free using intracorporeal 0-silk sutures. A 28-Fr intercostal drainage tube and a 12-Fr abdominal drain were placed.

Outcome: The postoperative course was uneventful. A chest x-ray on postoperative day one confirmed normal diaphragm position and re-expansion of the lung. The patient recovered without complications.

Conclusion: Laparoscopy provides a minimally invasive and effective diagnostic and therapeutic option for diaphragmatic rupture following blunt trauma. In appropriately selected cases, it offers favorable outcomes with reduced morbidity.