Spontaneous Diaphragmatic Rupture in Muscular Dystrophy Misdiagnosed as Pneumothorax: a Case Report

Diaphragmatic rupture is almost always iatrogenic with variable presentation. It should be diagnosed with high suspicion index in blunt thoracic trauma cases. Muscular dystrophy is associated with diaphragmatic muscle weakness. Spontaneous pneumothorax is also common in cases of muscular dystrophy which might be asymptomatic. The knowledge of muscular dystrophy and its varied presentation including the rare presentation of spontaneous diaphragmatic rupture is very important to the clinicians. This was a case of a 9-year-old male child who presented with a semi-acute diaphragmatic hernia that was misdiagnosed as pneumothorax, and a faulty chest drain insertion was done in a background of chronic muscular dystrophy which was later repaired. Clinicians are to have a high index of suspicion in treating patients of muscular dystrophy as they are prone to have rare presentations. A placement of Ryle’s tube before placing intercostal drainage would have prevented the misdiagnosis of the pneumothorax.