Life threatening rupture of the diaphragm after Covid 19 pneumonia: a case report
Abstract Background The incidence of diaphragmatic rupture is low; however, it may be life threatening. Normally caused by blunt trauma, some cases are reported after pulmonary infections with extensive coughing. Covid 19 causes pulmonary infections and pneumonia and has been associated with weakeni...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-022-01886-8 |
| _version_ | 1811247870024613888 |
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| author | Arvin Imamović Doris Wagner Jörg Lindenmann Nicole Fink-Neuböck Siegfried Sauseng Tarik Bajric Georg Werkgartner Hans Jörg Mischinger |
| author_facet | Arvin Imamović Doris Wagner Jörg Lindenmann Nicole Fink-Neuböck Siegfried Sauseng Tarik Bajric Georg Werkgartner Hans Jörg Mischinger |
| author_sort | Arvin Imamović |
| collection | DOAJ |
| description | Abstract Background The incidence of diaphragmatic rupture is low; however, it may be life threatening. Normally caused by blunt trauma, some cases are reported after pulmonary infections with extensive coughing. Covid 19 causes pulmonary infections and pneumonia and has been associated with weakening of the diaphragm after prolonged ventilation. We present a patient who suffered from diaphragmatic rupture 2 months after recovering from a severe Covid 19 pneumonia. Case A 71 years old male patient presented with massive thoraco-abdominal pain and severe dyspnea. At the time of admission, the patient was diagnosed with rupture of the diaphragm and developed cardiogenic shock. Intraoperatively there was a 4 cm diameter large rupture of the diaphragm with enterothorax (transverse colon, stomach, spleen, parts of the jejunum). Avulsion of the mesenteric arteries made a segmental resection of the jejunum together with the spleen necessary. A jejuno-jejunostomy was performed and organs were replaced into the abdomen. The rupture of the diaphragm underwent primary closure with non-resorbable suture material. The patient has shown an uneventful post-operative course, fully recovered and was discharged on day 11 after surgery. Conclusion Covid 19 is a disease that is known to have various effects on different organs. The diaphragm is only paid heed in case of dysfunction. Also in the setting of Covid 19 it is not known as prominent effector organ. Nevertheless its affection by coughing caused by Covid 19 can lead to life threatening complications. |
| first_indexed | 2024-04-12T15:17:04Z |
| format | Article |
| id | doaj.art-13a84c95d13a4437b030ef8e4b753a00 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-12T15:17:04Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-13a84c95d13a4437b030ef8e4b753a002022-12-22T03:27:35ZengBMCJournal of Cardiothoracic Surgery1749-80902022-06-011711410.1186/s13019-022-01886-8Life threatening rupture of the diaphragm after Covid 19 pneumonia: a case reportArvin Imamović0Doris Wagner1Jörg Lindenmann2Nicole Fink-Neuböck3Siegfried Sauseng4Tarik Bajric5Georg Werkgartner6Hans Jörg Mischinger7General, Visceral and Transplant Surgery, Medical University of GrazGeneral, Visceral and Transplant Surgery, Medical University of GrazDivision for Thoracic Surgery, Dept. of Surgery, Medical University of GrazDivision for Thoracic Surgery, Dept. of Surgery, Medical University of GrazGeneral, Visceral and Transplant Surgery, Medical University of GrazGeneral, Visceral and Transplant Surgery, Medical University of GrazGeneral, Visceral and Transplant Surgery, Medical University of GrazGeneral, Visceral and Transplant Surgery, Medical University of GrazAbstract Background The incidence of diaphragmatic rupture is low; however, it may be life threatening. Normally caused by blunt trauma, some cases are reported after pulmonary infections with extensive coughing. Covid 19 causes pulmonary infections and pneumonia and has been associated with weakening of the diaphragm after prolonged ventilation. We present a patient who suffered from diaphragmatic rupture 2 months after recovering from a severe Covid 19 pneumonia. Case A 71 years old male patient presented with massive thoraco-abdominal pain and severe dyspnea. At the time of admission, the patient was diagnosed with rupture of the diaphragm and developed cardiogenic shock. Intraoperatively there was a 4 cm diameter large rupture of the diaphragm with enterothorax (transverse colon, stomach, spleen, parts of the jejunum). Avulsion of the mesenteric arteries made a segmental resection of the jejunum together with the spleen necessary. A jejuno-jejunostomy was performed and organs were replaced into the abdomen. The rupture of the diaphragm underwent primary closure with non-resorbable suture material. The patient has shown an uneventful post-operative course, fully recovered and was discharged on day 11 after surgery. Conclusion Covid 19 is a disease that is known to have various effects on different organs. The diaphragm is only paid heed in case of dysfunction. Also in the setting of Covid 19 it is not known as prominent effector organ. Nevertheless its affection by coughing caused by Covid 19 can lead to life threatening complications.https://doi.org/10.1186/s13019-022-01886-8Covid 19CoughDiaphragmDiaphragmatic rupturePneumonia |
| spellingShingle | Arvin Imamović Doris Wagner Jörg Lindenmann Nicole Fink-Neuböck Siegfried Sauseng Tarik Bajric Georg Werkgartner Hans Jörg Mischinger Life threatening rupture of the diaphragm after Covid 19 pneumonia: a case report Journal of Cardiothoracic Surgery Covid 19 Cough Diaphragm Diaphragmatic rupture Pneumonia |
| title | Life threatening rupture of the diaphragm after Covid 19 pneumonia: a case report |
| title_full | Life threatening rupture of the diaphragm after Covid 19 pneumonia: a case report |
| title_fullStr | Life threatening rupture of the diaphragm after Covid 19 pneumonia: a case report |
| title_full_unstemmed | Life threatening rupture of the diaphragm after Covid 19 pneumonia: a case report |
| title_short | Life threatening rupture of the diaphragm after Covid 19 pneumonia: a case report |
| title_sort | life threatening rupture of the diaphragm after covid 19 pneumonia a case report |
| topic | Covid 19 Cough Diaphragm Diaphragmatic rupture Pneumonia |
| url | https://doi.org/10.1186/s13019-022-01886-8 |
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