Medical image of the week: post-trumatic diaphragmatic rupture

Abstract

No abstract available. Article truncated at 150 words. A 67-year-old woman was admitted after being struck by a vehicle, at high speed. She has a diaphragmatic rupture (Figures 1 and 2). Diaphragmatic injuries occur in approximately 0.8%–8% of blunt trauma patients, largely from motor vehicle accidents (1). The mechanism of injury includes distortion of the chest wall with resulting shearing forces, or direct frontal impact with acute increased intraabdominal pressure (2). Rupture of the left diaphragm is more common, presumably due to a protective mechanism by the liver, but also in part due to underdiagnoses (3). Most ruptures are large, posterolateral, between the lumbar and intercostal attachments (4). Associated liver injuries are seen mostly with right diaphragmatic injuries (93 % vs. 24% with left injuries). Multiorgan abdominal injury and pelvic fractures are common (2). In cases of associated hemothorax, pulmonary laceration/contusion, atelectasis, and phrenic nerve palsy, a diaphragmatic injury, may be masked on chest radiographs. Also, the …

Keywords

• trauma
• diaphragm
• rupture
• hernia
• chest x-ray
• CT scan
• dependent viscera sign
• collar sign
• liver laceration
• hemothorax