PMC7708859_01
Chest Xray showing elevation of left hemidiaphragm and opacities in the left thorax with the needle used for decompression.
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Chest x-ray (Fig. 1) however showed raised left hemidiaphragm with heterogeneous opacities over the left upper zone.
CT scan showing herniation of abdominal content into the left hemithorax.
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Tomography (CECT) was done which revealed left diaphragmatic rupture with herniation of stomach, small bowel, large bowel and spleen in the left thoracic cavity with left hemopneumothorax, left lung contusion, grade IV splenic injury, grade I left kidney injury, left posterior 6th to 10th ribs fracture, spinous process of T2 to T6 vertebrae fracture and comminuted fracture of left scapula (Fig. 2). There was no extravasation of contrast.
Defect in the Diaphragm (open and thoracoscopic views).
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Posterior segment of the left diaphragm had defects of 10 x 8 cm, 2 x 3 cm and 1 x 2 cm (Fig. 3). Intrathoracic cavity was also visualized via thoracoscopy (Fig. 3).
Lacerated Spleen for which splenectomy had to be done.
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Hernial contents were reduced, jejunal perforation was closed and splenectomy was done (Fig. 4).
Post operative Chest Xray with chest tube in situ.
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Postoperative X-Ray was done (Fig. 5).