Blunt Diaphragm Rupture

Imaging hemidiaphragmatic injury

“…The location of the diaphragm and its proximity to adjacent intrathoracic and intraabdominal organs accounts for associated injuries, which occur in 52-100% of patients [1,7,11,15,29,31]. Intrathoracic injuries such as pneumohemothoraces and multiple rib fractures are seen in 90% of patients with blunt DI [17,30,31].…”

“…Intrathoracic injuries such as pneumohemothoraces and multiple rib fractures are seen in 90% of patients with blunt DI [17,30,31]. Meyers et al [9] reported a 5% incidence of aortic injury in 68 patients with diaphragm rupture at a level I trauma center.…”

“…This may account for the great variability (7-66%) of initially missed DI seen in polytrauma patients reported in the literature [3,24,30,31,33,34]. Admission radiographs are diagnostic in 27-62% of patients with left-sided and in 18-33% of cases with right-sided injuries [1,17,26,35,36].…”

“…As concurrent trauma related acute pulmonary abnormalities in the lower thorax resolve, findings of DI may become more evident on radiographis obtained in the subacute or chronic phase. The diagnosis of DI may be delayed for patients receiving positive pressure ventilatory support, since the natural pressure gradient across the pleuro-peritoneal cavity is abolished or reversed and visceral herniation may not occur until positive pressure ventilator support is terminated [17,31]. 16-slice 150 ml 300 mg/ml 90 ml-6 ml/s Bolus pro a 0.75 mm 0.938 0.5 s Ascending aorta 60 ml-4 ml/s 40-slice <50 years 100 ml 350 mg/ml N.saline 50 ml-6 ml/s 18 s 0.625 mm 0.976 0.5 s Ascending aorta 50 ml-4 ml/s 50 ml-5 ml/s 40-slice >50 years 100 ml 350 mg/ml N.saline 50 ml-6 ml/s Bolus pro a 0.625 mm 0.976 0.5 s Ascending aorta 50 ml-4 ml/s 50 ml-5 ml/s a Threshold, 90 Hu…”

Traumatic Rupture of the Diaphragm: A Rare Cause of Pneumoperitoneum

“…1 Pneumoperitoneum without evidence of peritonitis and secondary to pulmonary air leaks and rupture of the diaphragm makes a clinical situation more complex and unusual. To our knowledge, only a few cases similar to the following one have been reported in the literature.…”