Review

A review on delayed presentation of diaphragmatic rupture

Farhan Rashid^1,2 , Mallicka M Chakrabarty^1,2 , Rajeev Singh³ and Syed Y Iftikhar^1,2

¹  Division of GI Surgery, University of Nottingham, Graduate Entry Medical School, Uttoxeter Road, Derby, DE22 3DT, UK

²  Department of Upper GI Surgery, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE, UK

³  Department of Radiology, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE, UK

author email corresponding author email

World Journal of Emergency Surgery 2009, 4:32doi:10.1186/1749-7922-4-32

Published:	21 August 2009

Abstract

Diaphragmatic rupture is a life-threatening condition. Diaphragmatic injuries are quite uncommon and often result from either blunt or penetrating trauma. Diaphragmatic ruptures are usually associated with abdominal trauma however, it can occur in isolation. Acute traumatic rupture of the diaphragm may go unnoticed and there is often a delay between the injury and the diagnosis. A comprehensive literature search was performed using the terms "delayed presentation of post traumatic diaphragmatic rupture" and "delayed diaphragmatic rupture". The diagnostic and management challenges encountered are discussed, together with strategies for dealing with them. We have focussed on mechanism of injury, duration, presentation and site of injury, visceral herniation, investigations and different approaches for repair. We intend to stress on the importance of delay in presentation of diaphragmatic rupture and to provide a review on the available investigations and treatment methods. The enclosed case report also emphasizes on the delayed presentation, diagnostic challenges and the advantages of laparoscopic repair of delayed diaphragmatic rupture.