article · Georgian Medical Journal
Post-traumatic diaphragmatic injuries are uncommon but carry significant risks to life. Diagnosing these injuries early is often difficult because their signs can be non-specific or obscured by other injuries across the chest and abdomen. This report details the management of a 30-year-old man who sustained a left-sided penetrating knife wound to the chest. The injury resulted in a ruptured diaphragm, leading to the stomach herniating and perforating within the pleural cavity. The patient exhibited respiratory distress and unstable vital signs, necessitating rapid intubation. A thoracoabdominal computed tomography scan identified the internal damage. Emergency surgery via a left anterolateral thoracotomy repaired the simultaneous injuries to the patient's lung, stomach, and diaphragm. The patient achieved an uneventful recovery following the operation.
Penetrating chest trauma can cause hidden internal tears that allow abdominal organs to enter the chest cavity. If organs like the stomach rupture inside the chest, they cause severe breathing problems and dangerous infections. Demonstrating that rapid imaging and prompt surgical intervention successfully resolve such combined injuries provides clinical teams with valuable insights for managing critical trauma emergencies.
The abstract does not indicate an application pathway, as it reports a single clinical case using standard surgical techniques and existing diagnostic imaging.
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Background: Post-traumatic diaphragmatic injury is a rare but life-threatening condition. Early diagnosis remains challenging, as clinical signs may be nonspecific and masked by associated thoracoabdominal injuries. Case presentation: We report the case of a 30-year-old male who sustained a left-sided penetrating thoracic trauma from a knife assault, complicated by diaphragmatic rupture with gastric herniation and perforation into the pleural cavity. The patient presented with haemodynamic instability and respiratory distress requiring emergent intubation. Thoracoabdominal CT scan confirmed the diagnosis. Emergency left anterolateral thoracotomy allowed repair of concomitant pulmonary, gastric, and diaphragmatic injuries. Postoperative recovery was uneventful. Conclusion: This case highlights the critical importance of early radiological assessment and timely surgical management in post-traumatic diaphragmatic injury to prevent severe respiratory and digestive complications. Comprehensive intraoperative exploration and vigilant postoperative care are essential to optimise patient outcomes. Keywords: diaphragmatic rupture; penetrating trauma; gastric herniation; gastric perforation; thoracotomy; case report
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DOI: 10.66636/gmj.v1.i3.a167
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