Diaphragmatic injury is a rare entity and clinically difficult to be diagnosed as symptoms are often masked due to associated injury in a poly trauma case. There are no specific signs and symptoms for diagnosing diaphragmatic rupture. High degree of clinical suspicion is needed in all cases of thoraco-abdominal injury to diagnose a case of diaphragmatic rupture. Cardiovascular and Thoracic compromise secondary to Large Diaphragmatic hernia can be significant and needs consideration and immediate intervention
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