Minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma: a case report
Pericardial rupture with cardiac herniation is a rare injury that occurs following blunt trauma. It is even more unusual to find a pericardial tear associated with diaphragmatic injury after such trauma. Diagnosing this condition through radiologic imaging is challenging. A 51-year-old man was admit...
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Korean Society of Traumatology
2025-03-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2024-0045.pdf |
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| author | Ranti Kenny Maila Kenny Nyiko Mongwe Mirza Mohamod Zahir Uddin Bhuiyan |
| author_facet | Ranti Kenny Maila Kenny Nyiko Mongwe Mirza Mohamod Zahir Uddin Bhuiyan |
| author_sort | Ranti Kenny Maila |
| collection | DOAJ |
| description | Pericardial rupture with cardiac herniation is a rare injury that occurs following blunt trauma. It is even more unusual to find a pericardial tear associated with diaphragmatic injury after such trauma. Diagnosing this condition through radiologic imaging is challenging. A 51-year-old man was admitted to the emergency department after a wall collapsed on him. He reported overall body discomfort, breathlessness, chest pain, and abdominal discomfort. A plain x-ray revealed haziness in the left thoracic cavity and elevation of the left hemidiaphragm with collapse of the left lung. Additionally, a gastric shadow was seen within the left hemithorax, accompanied by a mediastinal shift to the right. An x-ray of the pelvis displayed fractures at the right sacroiliac joint, left superior pubic ramus, left inferior pubic ramus, and left anterior acetabular with displacement. A computed tomography scan indicated herniation of the stomach, splenic flexure, and spleen, but there was no clear evidence of pericardial laceration. The patient underwent emergency exploratory laparoscopy and thoracoscopy. During the laparoscopy, a significant defect was found in the left hemidiaphragm, along with a pericardial rupture that had led to cardiac herniation and visceral herniation of the stomach, splenic flexure, and spleen through the diaphragmatic tear. The abdominal visceral organs were repositioned into the abdomen, and the diaphragm was repaired. The heart was repositioned, and the pericardial defect was closed using thoracoscopic techniques. Pericardial rupture can be effectively managed using minimally invasive surgery. |
| format | Article |
| id | doaj-art-d7e39c4ec9ee4bc3bb1b561700d301c8 |
| institution | DOAJ |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-d7e39c4ec9ee4bc3bb1b561700d301c82025-08-20T03:04:20ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832025-03-01381515510.20408/jti.2024.00451332Minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma: a case reportRanti Kenny Maila0Kenny Nyiko Mongwe1Mirza Mohamod Zahir Uddin Bhuiyan2 Department of General Surgery, Mankweng Academic Hospital, Faculty of Health Sciences, University of Limpopo, Sovenga, South Africa Department of General Surgery, Mankweng Academic Hospital, Faculty of Health Sciences, University of Limpopo, Sovenga, South Africa Department of General Surgery, Mankweng Academic Hospital, Faculty of Health Sciences, University of Limpopo, Sovenga, South AfricaPericardial rupture with cardiac herniation is a rare injury that occurs following blunt trauma. It is even more unusual to find a pericardial tear associated with diaphragmatic injury after such trauma. Diagnosing this condition through radiologic imaging is challenging. A 51-year-old man was admitted to the emergency department after a wall collapsed on him. He reported overall body discomfort, breathlessness, chest pain, and abdominal discomfort. A plain x-ray revealed haziness in the left thoracic cavity and elevation of the left hemidiaphragm with collapse of the left lung. Additionally, a gastric shadow was seen within the left hemithorax, accompanied by a mediastinal shift to the right. An x-ray of the pelvis displayed fractures at the right sacroiliac joint, left superior pubic ramus, left inferior pubic ramus, and left anterior acetabular with displacement. A computed tomography scan indicated herniation of the stomach, splenic flexure, and spleen, but there was no clear evidence of pericardial laceration. The patient underwent emergency exploratory laparoscopy and thoracoscopy. During the laparoscopy, a significant defect was found in the left hemidiaphragm, along with a pericardial rupture that had led to cardiac herniation and visceral herniation of the stomach, splenic flexure, and spleen through the diaphragmatic tear. The abdominal visceral organs were repositioned into the abdomen, and the diaphragm was repaired. The heart was repositioned, and the pericardial defect was closed using thoracoscopic techniques. Pericardial rupture can be effectively managed using minimally invasive surgery.http://jtraumainj.org/upload/pdf/jti-2024-0045.pdfcardiac herniationdiaphragmatic rupturepericardial rupturecase reports |
| spellingShingle | Ranti Kenny Maila Kenny Nyiko Mongwe Mirza Mohamod Zahir Uddin Bhuiyan Minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma: a case report Journal of Trauma and Injury cardiac herniation diaphragmatic rupture pericardial rupture case reports |
| title | Minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma: a case report |
| title_full | Minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma: a case report |
| title_fullStr | Minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma: a case report |
| title_full_unstemmed | Minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma: a case report |
| title_short | Minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma: a case report |
| title_sort | minimally invasive surgery for concomitant pericardial and diaphragmatic rupture after blunt trauma a case report |
| topic | cardiac herniation diaphragmatic rupture pericardial rupture case reports |
| url | http://jtraumainj.org/upload/pdf/jti-2024-0045.pdf |
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