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Diaphragmatic tear in pregnancy induced by intractable vomiting: a case report and review of the literature

Objective: Nausea and vomiting of pregnancy, the most common medical condition of pregnancy, affects up to 80% of all pregnancies to some extent, and hyperemesis gravidarum does less than 1% of pregnant women. When hyperemesis gravidarum induces diaphragmatic tear, diagnosis can be missed because of nonspecific presentation with abdominal pain, nausea and vomiting. Methods: We reported a pregnant case suffering from intractable vomiting at the beginning of the second trimester (the 13th week of gestation) with delayed diagnosis of diaphragmatic tearing. Results: The patient was misdiagnosed initially, which delayed the surgical intervention and unnecessary abortion. Conclusion: It is worthwhile considering the maternal diaphragmatic cause as an unusual one of refractory vomiting accompanied by clinically significant progressive epigastric pain, distension and respiratory embarrassment.