Details

Autor(en) / Beteiligte

• Londe, Kevin
• Patel, Neelam
• Franga, Dion

Titel

Traumatic Rupture of Diaphragm and Chest Wall Secondary to COPD Exacerbation

Ist Teil von

• The American surgeon, 2019-08, Vol.85 (8), p.421-422

Ort / Verlag

Los Angeles, CA: SAGE Publications

Erscheinungsjahr

2019

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• A 67-year-old woman with history of COPD and tobacco abuse disorder presented to the ED for sudden onset of left upper quadrant pain after a forceful productive cough with yellow sputum that she developed two days prior with nausea and shortness of breath with deep breathing and was admitted to surgery for evaluation. Given the findings on the patient's CT scan, the patient was taken to the operating room for left thoracotomy and repair of the traumatic diaphragmatic herniation. There are many factors that can cause diaphragmatic weakening in COPD patients.2 Inspiratory muscle weakness was shown to be related to dyspnea, and weakness of the diaphragm can be caused by hyperinflation-induced diaphragmatic shortening.3 There have been several studies showing differences in metabolic and structural changes in patients with and without COPD in terms of their diaphragm.3 COPD can significantly reduce the ventilatory capacity of the diaphragm because it has been found that patients with COPD have lower transdiaphragmatic pressures compared with healthy subjects without COPD.4 This lowered pressure is due to diaphragmatic shortening because of the hyperinflation of the lungs.5 Although blunt injury of the diaphragm is very common and usually secondary to severe injury, other coexisting injuries can mask its initial presentation.