The AAO Journal, 2024/06, 34(2):9. doi: 10.53702/i2375-5717-34.2.7, type of study: ,cr,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://meridian.allenpress.com/aaoj/article/34/2/7/500955/LBORC-NUFA-Poster-Abstracts-2024-Clinician-amp)

Keywords:

case report [736]
diaphragm [99]
injury [113]
male [861]
OMT [3925]
osteopathic manipulative treatment [3946]
spleen [5]
splenic rupture [2]

Abstract:

Introduction/Background: Diaphragmatic motion is a major driver for the lymphatic system. It affects both the intrathoracic and intraabdominal pressure. Its’ pumping motion serves to aid in the reabsorption of fluids in the abdominal cavity. In many traumatic injuries diaphragmatic motion becomes hindered affecting the ability of the diaphragm to pump fluids. Herein we present a case demonstrating the importance of diaphragmatic motion in post-traumatic injury. Case: Our patient is a 56-year-old male with complaint of diffuse abdominal pain. Two days prior he was discharged from the hospital with left rib 9 and 10 fractures, small splenic laceration, and a perihepatic hematoma in stable condition. Imaging of the abdomen showed signs of delayed splenic rupture with hemoperitoneum. Following emergent splenic artery embolization our team was consulted. The patient was treated with OMT throughout admission, utilizing various modalities including balanced ligamentous tension and myofascial release with focus on improving his respiratory-circulatory functioning. Results: After application of OMT the patient had reduction in the severity of his somatic dysfunction and reduced pain. Reevaluation and continued treatment throughout hospitalization showed continued improvement in the severity of his somatic dysfunction, including improved diaphragmatic motion. Discussion: The case presented provides a window for examining the role of diaphragmatic function. Peritoneal fluid is reabsorbed through localized lymph vessels to the lymph nodes in the mesenteric and celiac areas and through specialized lacunae on the undersurface of the diaphragm. By treating this patient’s somatic dysfunction, we were able to improve his diaphragmatic motion which aided reabsorption of his hemoperitoneum. Our hope is that future study can be done to further look at the various roles of diaphragmatic motion in post trauma patients.