Traumatic rupture of the diaphragm: a difficult diagnosis

• Published in: Injury Vol. 22; no. 4; pp. 299 - 302
• Main Authors: Maddox, P.R., Mansel, R.E., Butchart, E.G.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.07.1991; Elsevier
• Subjects: Accidents, Traffic; Adult; Biological and medical sciences; Diaphragm - injuries; Female; Hernia, Diaphragmatic, Traumatic - diagnostic imaging; Hernia, Diaphragmatic, Traumatic - etiology; Humans; Injuries of the thorax. Foreign bodies. Diseases due to physical agents; Male; Medical sciences; Middle Aged; Obstetric Labor Complications - diagnostic imaging; Pregnancy; Radiography; Rupture - diagnostic imaging; Rupture - etiology; Traumas. Diseases due to physical agents; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - diagnostic imaging; Case study; Human; Respiratory disease; Tissue rupture; Thorax; Diagnosis; Diaphragm; Trauma
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/0020-1383(91)90010-C

Rupture of the diaphragm occurs in approximately 5 per cent of cases of severe blunt trauma to the trunk, and the mortality may be as high as 50 per cent. The diagnosis is important because of the high incidence of associated organ damage and complications of a missed injury. Successful diagnosis requires a high index of suspicion but can be made from the chest radiograph in 90 per cent of cases if visceral herniation has occurred. We present three cases of rupture of the diaphragm which highlight the frequent occurrence of a delayed or missed diagnosis.