CASE 552 Published on 24.10.2000

Concomitant pericardial and left diaphragmatic rupture, with intrathoracic herniation of the stomach and of the spleen

Section

Chest imaging

Case Type

Clinical Cases

Authors

M. Wintermark, P. Vock, P. Schnyder

Patient

71 years, female

Categories

No Area of Interest ; Imaging Technique CT

No Procedure ; No Special Focus ;

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Clinical History

High-speed car accident

Imaging Findings

71-year-old female car passenger involved in a high-speed traffic accident

Discussion

Diaphragm usually ruptures into the pleural cavity. In less than 1% of cases, rupture of the diaphragmatic pericardium occurs concomittantly with a tear of the diaphragmatic central tendon. This sometimes allows for herniation of the stomach, transverse colon or omentum into the pericardium.

Differential Diagnosis List

Concomitant blunt traumatic pericardial and left diaphragmatic rupture, with intrathoracic herniation of the stomach and of the spleen

Final Diagnosis

Concomitant blunt traumatic pericardial and left diaphragmatic rupture, with intrathoracic herniation of the stomach and of the spleen

References

[1] Aldhoheyan A, Jain SK, Hamdy M, Alsebayel MJ.
Traumatic intrapericardial diaphragmatic hernia.
Injury. 1992;23(5):331-2. (PMID: 1644466)

[2] Bank H, Sinkover H, Ophir M, Shulemson M.
Traumatic diaphragmatic transpericardial hernia.
Br Med J. 1971 Jun 12;2(762):629-30. (PMID: 5580723)

[3] Galindo Gallego M, Lopez-Cambra MJ, Fernandez-Acenero MJ, et al.
Traumatic rupture of the pericardium. Case report and literature review.
J Cardiovasc Surg (Torino) 1996 37: 187-191. (PMID: 8675529)

[4] Morrison JA, Mullens JE.
Traumatic intrapericardial rupture of the diaphragm.
J Trauma. 1978 Oct;18(10):744-5. (PMID: 702617)

[5] Wintermark M, Schnyder P
Trauma of the diaphragm. In Schnyder P, Wintermark M. Radiology of blunt trauma of the chest. Springer, Berlin Heidelberg New York, pp 29-43 (2000).

Case information

URL:	https://www.eurorad.org/case/552
DOI:	10.1594/EURORAD/CASE.552
ISSN:	1563-4086

Figure 1

Concomitant pericardial and left diaphragmatic rupture, with intrathoracic herniation of the stomach and of the spleen

Spiral CT section (5-mm) on T10 level demonstrates concomitant pericardial rupture (arrow) and left diaphragmatic rupture, with intrathoracic herniation of the stomach and of the spleen (From Wintermark M, Schnyder P (2000) Trauma of the diaphragm. In Schnyder P, Wintermark M. Radiology of blunt trauma of the chest. Springer, Berlin Heidelberg New York, pp 29-43)