Pregnancy complicated by traumatic diaphragmatic rupture - A case report

BACKGROUND: Diaphragmatic rupture may be easily overlooked at the time of m ultiple trauma. Occult diaphragmatic rupture may first manifest during preg nancy as severe dyspnea. CASE: A parous woman who had sustained multiple traumatic injuries prior to pregnancy presented in midtrimester with abdominal pain and dyspnea. Chest roentgenography and computed tomography revealed bowel in the left hemitho rax, compatible with a left-sided diaphragmatic rupture. Surgical correctio n was indicated secondary to the symptomatic nature of the presentation. CONCLUSION: Diaphragmatic rupture may be occult and may first present durin g a subsequent pregnancy. Surgical therapy is the cornerstone of management when a diaphragmatic defect is symptomatic. The route of delivery may be i ndividualized for patients with diaphragmatic repairs in whom there has bee n sufficient time for healing.