A case of a diaphragmatic rupture complicated with lacerations of stomach and spleen caused by a violent cough presenting with mediastinal shift

Abstract

Introduction: Diapraghmatic rupture is a clinical case that is mostly seen following a blunt thoracoabdominal trauma or is rarely reported as spontaneously induced by various factors. Clinical Picture: A 28-year-old man presented as an emergency with shortness of breath and severe abdominal pain following a violent cough. His chest radiography and computed tomography demonstrated left diaphragmatic rapture, mediastinal shift and herniation of gastric fundus into the pleural cavity. Treatment: Left thoracotomy for the replacement of herniated gastric fundus and median laparotomy for the repair of serosal layer of gastric fondus and a diaphragmatic gap were performed. Outcome: He made an uneventful recovery. Conclusions: Diaphragmatic ruptures may be caused by violent coughing with serious life-threatening complications.