Acosta GG, Delgado LF, Guerra CY

Language: Spanish
References: 12
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ABSTRACT

Introduction: the diaphragm is a septum that separates the thorax from the abdomen and its physiological function is to help the mechanics of ventilation. Traumatic diaphragmatic rupture is an entity of difficult initial diagnosis, due to low clinical suspicion, which leads to complications such as strangulation, which has high morbidity and mortality. Traumatic injuries to the diaphragm are rare, the overall incidence due to penetrating and closed mechanism is 1% to 6%.
Case presentation: 20-year-old male patient with apparent health history, attended the emergency service 2 hours after having suffered an occupational accident when a sandbar fell off him, reporting difficulty breathing and chest pain in hemithorax On the left, the imaging studies performed showed the presence of a gastric chamber and colon in the left hemithorax, he was operated on with a diagnostic impression of a diaphragmatic rupture secondary to blunt abdominal trauma. During the intraoperative it was verified (linear laceration involving the entire left hemidiaphragm) with herniation of the stomach, spleen, transverse colon and part of the small intestine in the thoracic cavity. Left low pleurostomy and frenorrhaphy were performed. No other intra-abdominal alterations.
Discussion: traumatic diaphragm rupture is an infrequent injury that occurs as a consequence of blunt and penetrating trauma to the abdomen or chest. Early diagnosis of it continues to be a challenge and is associated with high morbidity and mortality. Preoperative diagnosis is difficult and only a high level of suspicion, a thorough examination of imaging techniques, and immediate surgical intervention are decisive for the success of treating these patients.
Conclusions: our patient did not present major complications in the perioperative period, at 24 hours he was on a diet and wandering, the pleural tube was removed at 72 hours and has had a favorable symptom-free evolution, being discharged at 10 days.

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