Traumatic diaphragmatic rupture and left chest wall herniation

Blunt diaphragmatic rupture is a rare injury with a high mortality rate. The pathophysiological mechanism of diaphragmatic rupture is hypothesized as an increase in intra-abdominal pressure leading to muscular disruption and subsequent visceral herniation into the pleural cavity. Left-side ruptures are more common, as the right side is protected by the liver. Abdominal contents occupying the chest cavity can become ischaemic or could have been injured during the initial trauma and, additionally, might significantly compress the lung, leading to a variety of clinical presentations ranging from chest pain and peritonitis to increased rate of breathing or respiratory distress. In this video tutorial, we present a polytrauma patient after a motor vehicle collision, who sustained traumatic diaphragmatic rupture and left chest wall herniation.