Iatrogenic stomach perforation complicating unrecognized posttraumatic diaphragmatic hernia (Gastro Thorax)

Abstract

We report a case of 21-year-old male patient with traumatic diaphragmatic herniation of the stomach that is misdiagnosed as a hemo-pneumothorax with the resulting insertion of a chest tube causing iatrogenic perforation of the stomach and draining of gastric content into the pleural cavity. An emergency thoracotomy was performed, and the stomach has been repaired and reduced to the abdomen, followed by repair of the left diaphragm. Postoperative wound infection due to residual empyema was treated aggressively. We discussed and highlighted the diagnostic approach to clinical management of traumatic diaphragmatic rupture (TDR) and the importance of using nasogastric (NG) tube to avoid occurrence of such iatrogenic trauma.

Key words: Diaphragmatic rupture Stomach perforation.