Isolated Left Diaphragmatic Injury from Unusual form of Trauma

Abstract

Diaphragmatic injury following blunt abdominal trauma is an often missed diagnosis in the emergency setting unless looked for specifically,  

We present the case of a 47 year old manual laborer who presented to casualty with history of a fall from a tree on to his back. He complained of pain in the left shoulder and back.  

A plain X ray of the chest showed a left scapular fracture and tenting of the left hemi diaphragm with stomach fundic gas shadow and colonic shadows in the left lower zone. A contrast enhanced computed tomogram of the lower chest and abdomen showed a rupture of the left hemi diaphragm with herniation of the stomach fundus and body and distal transverse colon into left hemi thorax.