Spontaneous Right-Sided Diaphragmatic Rupture with Liver Herniation after Bilateral Lung Transplantation

Spontaneous diaphragmatic rupture is a rare but life-threatening complication. We report the case of a 53-year-old female who developed acute right-sided diaphragmatic rupture with liver, gallbladder and transverse colon herniation six days after bilateral lung-transplantation for end-stage chronic obstructive pulmonary disease. The event followed forceful vomiting and caused cardiac tamponade due to compression. Emergency surgical repair required a combined thoracic and abdominal approach with mesh reconstruction of the diaphragm. Prompt recognition, careful perioperative positioning, and multidisciplinary management enabled uncomplicated postoperative recovery. This case underscores the importance of early imaging and decisive surgical intervention in atypical postoperative deterioration following lung transplantation.