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Delayed presentation of a patient with a ruptured diaphragm complicated by gastric incarceration and perforation after apparently minor blunt trauma

Published online by Cambridge University Press:  21 May 2015

Brian K.P. Goh ,
Andrew S.Y. Wong ,
Khoon-Hean Tay  and
Michael N.Y. Hoe
Brian K.P. Goh*
Affiliation:
Department of General Surgery, Changi General Hospital, Singapore
Andrew S.Y. Wong
Affiliation:
Department of General Surgery, Changi General Hospital, Singapore
Khoon-Hean Tay
Affiliation:
Department of General Surgery, Changi General Hospital, Singapore
Michael N.Y. Hoe
Affiliation:
Department of General Surgery, Changi General Hospital, Singapore
*
Department of General Surgery, Changi General Hospital, 2, Simei St. 3, Singapore 520880; fax +65-67880933, bsgkp@hotmail.com

Abstract

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Rupture of the diaphragm is almost always due to major trauma and is most commonly associated with road-traffic accidents. We report a case of delayed presentation of a 35-year-old woman with a ruptured diaphragm, 11 days following apparent minor blunt trauma. This case illustrates how the diagnosis of ruptured diaphragm can be missed and demonstrates the importance of considering this diagnosis in all cases of blunt trauma to the trunk. It also demonstrates the potential pitfall of misinterpreting the chest radiograph, and the value of repeat imaging after insertion of a nasogastric tube.

Keywords

delayed presentationruptured diaphragmminor blunt traumagastric incarcerationgastric perforation
Type
Case Report • Observations de cas
Information
Canadian Journal of Emergency Medicine , Volume 6 , Issue 4 , July 2004 , pp. 277 - 280
Copyright
Copyright © Canadian Association of Emergency Physicians 2004

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