Intrathoracic gastric perforation secondary to post-traumatic diaphragmatic rupture: a case report

Abstract

Background: Post-traumatic diaphragmatic injury is a rare but life-threatening condition. Early diagnosis remains challenging, as clinical signs may be nonspecific and masked by associated thoracoabdominal injuries. Case presentation: We report the case of a 30-year-old male who sustained a left-sided penetrating thoracic trauma from a knife assault, complicated by diaphragmatic rupture with gastric herniation and perforation into the pleural cavity. The patient presented with haemodynamic instability and respiratory distress requiring emergent intubation. Thoracoabdominal CT scan confirmed the diagnosis. Emergency left anterolateral thoracotomy allowed repair of concomitant pulmonary, gastric, and diaphragmatic injuries. Postoperative recovery was uneventful. Conclusion: This case highlights the critical importance of early radiological assessment and timely surgical management in post-traumatic diaphragmatic injury to prevent severe respiratory and digestive complications. Comprehensive intraoperative exploration and vigilant postoperative care are essential to optimise patient outcomes. Keywords: diaphragmatic rupture; penetrating trauma; gastric herniation; gastric perforation; thoracotomy; case report