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A tension pneumothorax is a known life-threatening condition which requires a needle decompression. A diaphragmatic rupture is a relatively rare injury and is difficult to diagnose. A combination of a tension pneumothorax in presence of an ipsilateral diaphragmatic rupture can be called life-saving since the air in the pleural space is able to escape to the abdomen. The diagnosis of a diaphragmatic rupture by computed tomography or even by laparo- or thorascopy is crucial. Surgical repair should always be undertaken because the rupture will not close spontaneously and the risk of herniation of intra-abdominal organs to the pleural space will remain. In presence of a chest tube on suction, iatrogenic migration or even perforation of these organs can occur.

Tension pneumothorax and life saving diaphragmatic rupture: a case report and review of the literature