Diaphragmatic rupture overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Diaphragmatic rupture is a tear of the diaphragm, the muscle across the bottom of the ribcage that plays a crucial role in respiration. Most commonly, acquired diaphragmatic tears result from physical trauma. Diaphragmatic rupture can result from blunt or penetrating trauma[1] and occurs in about 5% of cases of severe blunt trauma to the trunk.[2]

Diagnostic techniques include X-ray, computed tomography, and surgical techniques such as laparotomy. Diagnosis is often difficult because signs may not show up on X-ray, or signs that do show up appear similar to other conditions. Signs and symptoms included chest and abdominal pain, difficulty breathing, and decreased lung sounds. When a tear is discovered, surgery is needed to repair it.

Injuries to the diaphragm are usually accompanied by other injuries, and they indicate that more severe injury may have occurred. The outcome often depends more on associated injuries than on the diaphragmatic injury itself.[3] Since the pressure is higher in the abdominal cavity than the chest cavity, rupture of the diaphragm is almost always associated with herniation of abdominal organs into the chest cavity, called traumatic diaphragmatic hernia.[4] This herniation can interfere with breathing, and blood supply can be cut off to organs that herniate through the diaphragm, damaging them.

References

  1. Sliker CW (2006). "Imaging of diaphragm injuries". Radiol Clin North Am. 44 (2): 199–211, vii. doi:10.1016/j.rcl.2005.10.003. PMID 16500203. Unknown parameter |month= ignored (help)
  2. Nolan JP (2002). "Major trauma". In Adams AP, Cashman JN, Grounds RM. Recent Advances in Anaesthesia and Intensive Care: Volume 22. London: Greenwich Medical Media. p. 182. ISBN 1-84110-117-6.
  3. Scharff JR, Naunheim KS (2007). "Traumatic diaphragmatic injuries". Thorac Surg Clin. 17 (1): 81–5. PMID 17650700. Unknown parameter |month= ignored (help)



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