Two-Stage Detected Traumatic Right Diaphragm Rupture after Blunt High-Velocity Trauma

A 30 years old healthy man was brought to our level-one trauma center after a high-velocity trauma. While riding a quad he was hit by a car with about 60 km/h. Initial scores of Glasgow Coma Scale (GCS) and injury severity score (ISS) were 15. Extremity trauma with moderate craniocerebral injury and abdominal trauma with splenic and hepatic laceration was diagnosed. During follow up on the intensive care unit (ICU) the patient reported unspecific abdominal pain and dyspnea. Sonographic controls of the thorax and abdomen showed a hemothorax and dilated intestinal loops. We therefore performed a re-computer tomography re-(CT) scan, which showed an ileus and a RTDR. After immediate laparotomy, suture of the diaphragm and partial ileus resection the patient was rehabilitated and discharged at day 34 post trauma.