Massive left diaphragmatic separation and rupture due to coughing during an asthma exacerbation

• Published in: Southern medical journal (Birmingham, Ala.) Vol. 93; no. 7; pp. 729 - 731
• Main Authors: KALLAY, N, GRIM, L, DUNAGAN, D. P, KAVANAGH, P. V, MEREDITH, W, HAPONIK, E. F
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.07.2000
• Subjects: Allergic diseases; Biological and medical sciences; Chest Pain - etiology; Cough - complications; Diaphragm - pathology; Dyspnea - etiology; Ecchymosis - etiology; Female; Hemorrhage - etiology; Hernia, Diaphragmatic - etiology; Humans; Immunopathology; Intercostal Muscles - pathology; Medical sciences; Middle Aged; Muscular Diseases - etiology; Pleurisy - etiology; Respiratory and ent allergic diseases; Rupture, Spontaneous; Status Asthmaticus - complications; Human; Respiratory disease; Acute; Spontaneous; Rupture; Trauma; Cough; Asthma; Crisis; Case study; Hernia; Respiratory muscle; Complication; Female; Obstructive pulmonary disease; Diaphragm
• ISSN: 0038-4348; 1541-8243
• DOI: 10.1097/00007611-200007000-00021

We report a case of herniation of abdominal contents into the left hemithorax in a patient hospitalized with an acute exacerbation of asthma accompanied by paroxysms of coughing. There was no history of trauma. We believe this is the first reported case of diaphragmatic rupture complicating an asthma exacerbation. We review clinical features, pathophysiology, diagnosis, and treatment of diaphragmatic rupture in its most common setting, trauma, and discuss its occasional "spontaneous" occurrence.