Diaphragmatic rupture
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Cause
In adults, rupture can occur due to aging, obesity, strenuous exercise or chronic coughing. Diaphragmatic rupture can also occur in newborns, in which case an error in diaphragm development is to blame.
Symptoms
The symptoms below may occur:
- Chest pain
- Breathing difficulties
- Reflux
Treatment
Treatment for a diaphragm rupture depends on the size and severity of the rupture. For small fractures, medication may help, with or without some lifestyle changes such as maintaining a healthy weight, quitting smoking and avoiding coffee, alcohol, chocolate and spicy foods.
Large fractures often require surgical repair. This is usually done through a laparoscopy, but can also be done through open surgery. The esophagus and stomach are brought back under the diaphragm and a collar is placed around the end of the esophagus. This prevents the stomach from re-entering the chest. A new gastric valve is formed.
Sometimes a mesh is needed to close the opening in the diaphragm.
Aftercare
After treatment of a diaphragmatic rupture, the following steps are important to follow to promote recovery and prevent another rupture:
- Avoid heavy, high-fat meals and eating smaller, frequent meals to reduce pressure on the diaphragm
- A healthy weight reduces the risk of a new fracture
- Smoking can cause chronic coughing, which increases pressure on the diaphragm. Quitting smoking can help reduce complications after surgery.