Closed traumatic rupture of the diaphragm

Abstract

Blunt ruptures of the diaphragm are rare. Most probably diagnosis and incidence are closely connected, because diaphragmatic ruptures are frequently misdiagnosed or even overlooked. We present the cases of 2 patients with blunt left-sided diaphragmatic rupture and discuss the challenging problem of secure diagnosis. One patient showed dyspnoea after mechanical respiration on ICU was terminated and spontaneous respiration started. Another patient suffered acute respiratory insufficiency while undergoing gastroscopy. Retrospectively he was found to have suffered a rupture of the diaphragm in the course of a traffic accident 2 years before which had been missed primarily. In the treatment of blunt diaphragmatic rupture, advantages of minimally invasive surgery as opposed to conventional surgery are increasingly discussed. In one of the presented cases, laparoscopy was used for diagnostic and therapeutic procedures.