Hepatothorax Caused by a Late Post-Traumatic Diaphragmatic Rupture

The patient is a 29-year-old male with dorsolumbar high-energy blunt trauma caused by a falling rock. Given his hemodynamic stability, emergency CT was ordered, which showed no diaphragm injury (Fig. 1). A chest tube was inserted and the pelvis was stabilized. On the third day, follow-up radiography showed an obscured right hemithorax, after which CT revealed rupture of the right diaphragm (Fig. 2). Right subcostal laparotomy was used (Fig. 3) to reduce the content and close the tear with continuous PDS loop^® suture that was later reinforced with a Proceed^® prosthesis attached with polypropylene suture and fibrin adhesive.

Fig. 1

Fig. 2

Fig. 3