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BMJ Case Reports 2012; doi:10.1136/bcr-2012-007372
  • Rare disease

Delayed presentation of post-traumatic diaphragm rupture repaired by laparoscopy

  1. Alberto Isla3
  1. 1Chelsea and Westminster Hospital,London,UK
  2. 2Department of Surgery and Cancer, Imperial College London, London, UK
  3. 3Department of Surgery, North West London Hospitals NHS Trust, Harrow, UK
  1. Correspondence to Dr James Houston, jameshouston{at}doctors.org.uk

Summary

Diaphragmatic rupture is a serious but frequently missed condition that is potentially curable. While surgical management has classically been performed through open thoracotomy, a laparoscopic approach has been suggested as a preferable alternative. A man in his mid-50s presented with non-specific abdominal symptoms, 8 months after falling down some stairs. Diaphragmatic rupture was suspected after old rib fractures were noticed on an admitting chest radiograph. Further signs and symptoms presented following deterioration due to the unstable pathology. Prompt surgical treatment using laparoscopy was attempted with success and resulted in rapid and lasting improvement in symptoms.

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