A Case of Traumatic Diaphragm Rupture: A Differential Diagnosis Not to Be Missed

Traumatic diaphragmatic rupture is a rare condition with clinical stigmata that overlaps with a similarly fatal condition such as tension pneumothorax. Although the former is much rarer, early differentiation between a ruptured diaphragm and a tension pneumothorax is crucial to avoid incorrect interventions. In this case, we present a middle-aged male construction worker who fell from the roof of a two-story building and presented to our emergency department with a clinical presentation similar to that of tension pneumothorax. However, a chest X-ray later revealed a left diaphragmatic hernia, which completely altered the management. This case helps highlight the importance of widening one's list of differential diagnoses, especially in the setting of a hectic environment and a vague presentation.

Pneumoperitoneum in a Patient With COVID-19 and Acute Respiratory Distress Syndrome Without Pneumothorax

We present a case report of pneumoperitoneum, pneumomediastinum, and subcutaneous emphysema in a patient with COVID-19 pneumonia-causing acute respiratory distress syndrome (ARDS) without any pneumothorax occurring. Pneumothorax, pneumomediastinum, and subcutaneous emphysema are known complications of barotrauma due to positive pressure from mechanical ventilation which is necessary for patients suffering from a severe case of COVID-19. In our literature search, we could not find any reported case of pneumoperitoneum without pneumothorax occurring. Our case is an important addition to the literature presenting a rare complication of mechanical ventilation in patients with ARDS.

Diffuse Alveolar Hemorrhage: A Rare Complication of Severe Hypertension

Severe hypertension is a rare cause of diffuse alveolar hemorrhage. We reported a case of a 43-year-old woman who presented with shortness of breath, hemoptysis, and severe hypertension. The patient was diagnosed with diffuse alveolar hemorrhage due to severe hypertension which improved after controlling her blood pressure.

Catamenial Pneumothorax in the Setting of a Recent Stroke

Catamenial pneumothorax is a unique condition associated with thoracic endometriosis. It often presents in females of reproductive age as a recurrent pneumothorax aligned with the menstrual cycle. We present a case of a young female diagnosed with catamenial pneumothorax within one year of experiencing a stroke. The clinical presentation related to the stroke allowed for a unique diagnostic process and management considerations. The patient was successfully treated with progesterone-based contraception in the setting of an estrogen contraindication.