Abstract

VAZQUEZ MINERO, Juan Carlos; TRUEBA LOZANO, Demian  and  PORTILLO TELLEZ, Laura. Image in thoracoabdominal trauma. A difficult differential diagnosis. Rev. Fac. Med. (Méx.) [online]. 2019, vol.62, n.2, pp.39-42.  Epub Oct 16, 2020. ISSN 2448-4865.  https://doi.org/10.22201/fm.24484865e.2019.62.2.07.

A 70-year-old male entered the emergency department after being hit by a car. He had bilateral thoracic pain and dyspnea. On the physical examination we found him with patent airway, absence of vesicular murmur in the lower portion of the right hemithorax in association with loss of hepatic dullness, hemodinamic stability, conscious with 15 points on the Glasgow coma scale. We obtained a plain thoracic x-ray, which revealed a radiolucent image over the liver; for that reason, we obtained a contrasted CT-scan which showed diaphragmatic integrity. This image finding may suggest a traumatic diaphragmatic rupture; however, it may be only a radiological finding.

Keywords : Chest trauma; diaphragm rupture; sign Chilaiditi; diaphragmatic paralysis; subdiaphragmatic free air.