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Association of Paediatric Surgeons of Bangladesh
Journal of Paediatric Surgeons of Bangladesh
Case Reports · Vol. 3 No. 2 (2012)

Diaphragmatic Rupture in a Boy Following Blunt Abdominal Trauma- A Case Report

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JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : July 2012
CONTENTSVolume 03Number 2July 2012
Editorial
Collaboration in Pediatric Surgical Training & Education among Asian Countries & Beyond – Bangladesh perspective
Abdul Hanif Tablu
54
Review Articles
Enuresis
Ashraf Ul Huq Kazal
78
Original Articles
Effect of Preoperative Chemotherapy in the Treatment of Advanced Wilms Tumor
Kaniz Hasina, Md Kamrul Hassan, Abdul Hanif, Abdur Rahed Khan, Muhammad Saiful Islam
56
Role of Ultrasound-Guided Hydrostatic Reduction of Intussusception in Children with Early Presentation
Md Shakhawat Hossain, Md Ashraf Ul Huq, Jafrul Hannan, Kaniz Hasina, RN Sarker
61
A Comparative Study to Evaluate the Outcome of Double Dartos Flap in Tubularized Incised Plate Urethroplasty for Distal Hypospadias Repair
Abhi Kumar Chakraborty, Sajal Kumar Majumdar, Mirza Kamrul Zahid, Sayed Mahmudur Rahman, Dipankar Kumar Saha, Khandoker Moynul Hasan
65
Incidence and Progress of Vesicoureteric Reflux after Primary Fulguration of Posteriorurethralvalves
MM Masud Pervez, Kaniz Hasina, Md Ashraf Ul Huq
71
Case Reports
Diaphragmatic Rupture in a Boy Following Blunt Abdominal Trauma- A Case Report
MA Mushfiqur Rahman, Md Minhajuddin Sajid, Md Abdullah Al Farooq, Md Akbar Husain Bhuiyan, Tanvir Kabir Chowdhury
81
Intestinal Atresia : A Case Report
Mohammad Shakhawat Hossain, Ashraf Ul Huq Kazal, Moinul Huque
85
Neuroblastoma neck in a 7-year-old girl: a very rare presentation
Rameez Shah, Sk Nurul Fatah Rumi
88
The Official Journal of the
ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
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Authors

  • MA Mushfiqur RahmanAssistant Professor, Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chittagong
  • Md Minhajuddin SajidAssistant Professor, Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chittagong
  • Md Abdullah Al FarooqAssistant Professor, Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chittagong
  • Md Akbar Husain BhuiyanAssociate Professor, Department of Pediatric Surgery, Chittagong Medical College & Hospital, Chittagong
  • Tanvir Kabir ChowdhuryPost graduate student, Department of Pediatric Surgery, Chittagong Medical College, Chittagong

Keywords

Blunt trauma Diaphragmatic rupture

Abstract

Traumatic rupture of the diaphragm is rarely observed in children with thoracoabdominal trauma. Although dyspnea is the commonest symptom, early diagnosis is difficult as chest radiography can diagnose only half of the cases. Prompt diagnosis and surgical repair is life saving. Patient may suffer from multiple associated injuries which is often fatal. A 8 years old boy was admitted with severe respiratory distress and restlessness follwing a history of landslide few hours back. He was pale, cyanosed with hypotension, tachycardia and sweating. Bruise noted over left upper abdomen and left lower chest wall. Surgical emphysema and restricted movement during respiration was noted in the left chest wall with absent breath sound. Abdomen was scaphoid having normal bowel sound. Resuscitation was started and insertion of left intercostal chest drain tube had failed to relieve respiratory distress. A portable chest radiograph showed the chest drain tube in abdomen with mediastinal shifting to opposite side and collapsed lung margin. Left dome of the diaphragm was not clearly visualized. Re institution of chest tube was planned for immediate relief and on withdrawal of the previous drain tube dragged the omentum with it. Then the diagnosis of diaphragmatic rupture was obvious. Laparotomy showed extensive tear of left hemidiaphragm with herniation of abdominal contents. Left costal margin was also torn but abdominal viscera were found intact. Repair was done with interrupted unabsorbable suture after keeping a chest drain tube. Post operatively the patient was kept in ward with adequate analgesia. Check X-ray on 1st post operative day, showed well expanded left lung. The patient had recovered well. Drain was removed on 3rd postoperative day and was discharged on 7th post operative day. High index of suspicion is needed for correct diagnosis. Outcome is satisfactory if treated in time without any associated injury.

Journal of Paediatric Surgeons of Bangladesh (2012) Vol. 3 (2): 81–84

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