Minimally Invasive Treatment of Traumatic Diaphragm Rupture

Diaphragmatic rupture is a rare but potentially life-threatening injury that can result from blunt or penetrating trauma. Timely diagnosis is critical to prevent serious complications, yet clinical and radiological assessments are often inconclusive. We report the case of a 39-year-old male patient who sustained blunt thoracoabdominal trauma in a motor vehicle accident. The patient presented with respiratory distress and generalized abdominal tenderness. Imaging revealed a left diaphragmatic defect with herniation of abdominal organs into the thoracic cavity. The patient underwent diagnostic laparoscopy, which confirmed an 8 × 5 cm defect in the left diaphragmatic dome with herniation of the stomach and omentum. The herniated organs were reduced, and the defect was repaired tension-free using intracorporeal 0-silk sutures. A 28-Fr intercostal drainage tube and a 12-Fr abdominal drain were placed. The postoperative course was uneventful. A chest x-ray on postoperative day one confirmed normal diaphragm position and re-expansion of the lung. The patient recovered without complications. Laparoscopy provides a minimally invasive and effective diagnostic and therapeutic option for diaphragmatic rupture following blunt trauma. In appropriately selected cases, it offers favorable outcomes with reduced morbidity.