{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T11:11:27Z","timestamp":1773054687114,"version":"3.50.1"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Traumatic diaphragmatic injury (TDI), although rare, is associated with high mortality and morbidity and timely recognition is important.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>We present a case of a 44-year-old male who fell from a three-story building and presented with complaints of shortness of breath and chest pain. On examination, his chest compression test and extended focused assessment with sonography in trauma (E-FAST) were positive. Chest X-ray showed loss of diaphragmatic contour, fracture of fifth to eleventh ribs on the left side, and opacities in the left hemithorax. Contrast-enhanced computed tomography of chest, abdomen, and pelvis showed bowel loops over the left hemithorax with grade 1 splenic injury. A diagnosis of ruptured diaphragmatic hernia with grade I splenic injury was made and emergency primary repair of the diaphragm was done via thoracotomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Clinical diagnosis of TDI is difficult and can be misdiagnosed as a pneumothorax. In addition, the subtle presentation can often be missed. CT scan of the chest and abdomen is the imaging of choice to reach a diagnosis. Once diagnosed, emergency surgery via laparotomy or thoracotomy is mandatory. Delay in diagnosis can have a fatal consequence or delayed complications which have high mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Diaphragmatic injury should be suspected in all blunt thoracoabdominal traumas, and the presence of this injury should be excluded to prevent late complications. Timely intervention can provide excellent outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2022.107556","type":"journal-article","created":{"date-parts":[[2022,8,28]],"date-time":"2022-08-28T01:48:50Z","timestamp":1661651330000},"page":"107556","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Ruptured diaphragmatic hernia with grade I splenic injury"],"prefix":"10.1097","volume":"98","author":[{"given":"Yagya Laxmi","family":"Shakya","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parbej","family":"Allam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aarjabi","family":"Silwal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sajana","family":"Acharya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shradha","family":"K.C.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samriddha Raj","family":"Pant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-79-20260309","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/j.amjsurg.2014.12.023","article-title":"Traumatic diaphragmatic injury in the American College of Surgeons National Trauma Data Bank: a new examination of a rare diagnosis","volume":"209","author":"Fair","year":"2015","journal-title":"Am. 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Surg"},{"key":"R15-79-20260309","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s12262-016-1484-z","article-title":"Thoracotomy for traumatic diaphragmatic hernia","volume":"78","author":"Fangbiao","year":"2016","journal-title":"Indian J. Surg"},{"key":"R16-79-20260309","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/S1052-3359(25)00338-2","article-title":"Adult presentation of unusual diaphragmatic hernias","volume":"8","author":"Naunheim","year":"1998","journal-title":"Chest Surg. Clin. N. 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