Traumatic Ruptured Diaphragm: A Clinical Diagnostic Dilemma

Abstract

Sequel to a car crash, Chief A, a 52-year old banker presented in the Orthopaedic Unit of University of Nigeria Teaching Hospital Enugu with fracture right forearm bones and minor bruises in the abdomen and buttocks. His fractured right forearm was treated surgically and patient was discharged. A month later, Chief A developed breathlessness and was therefore re-admitted in same hospital where radiological survey including plain chest radiography and tailored barium meal revealed a hitherto clinically Occult rupture left hemi-diaphragm with mediastinal shift to the contralateral side. We present this case to highlight the pleomorphism of traumatic rupture of diaphragm with emphasis on the causes, clinical presentation, complications, model of progression and different treatment options.