Diaphragm Rupture

Excerpt

The diaphragm is the arched, flat muscular structure that divides the thorax from the abdominal cavity. Diaphragmatic injuries are relatively uncommon, representing less than 1% of traumatic injuries. They are typically considered a marker of severe trauma due to the high rate of associated injury. Certain injury patterns increase the risk of diaphragmatic injury, and penetrating trauma is a more common mechanism than blunt trauma. While large diaphragmatic injuries may be clinically obvious in the acute setting, diaphragmatic injuries are often occult, and a high index of suspicion must be maintained to prevent missing this important diagnosis. A missed diaphragmatic injury may result in delayed herniation and strangulation of abdominal organs into the thoracic cavity through the unrepaired defect in the diaphragm. A thorough understanding of the anatomy, associated injuries, and pitfalls in diagnostic testing will assist in diagnosing this surgical condition.