TRAUMATIC RUPTURE OF THE DIAPHRAGM

  • 1 January 1982
    • journal article
    • research article
    • Vol. 154  (4) , 526-530
Abstract
The experience gained during a 16 yr period from 27 patients with traumatic rupture of the diaphragm is reported. Automobile accidents were the most frequent cause of diaphragmatic rupture and the left hemidiaphragm was that most often affected. The diagnosis is most frequently missed during the initial examination and treatment of such patients. The diagnosis was missed in the present material in 48% of the patients during the first 24 h. The preoperative diagnosis is based upon the suspicion that all patients with traumatic injuries to the thoracoabdominal region may have a rupture of the diaphragm. An ordinary roentgenogram of the chest gives rise to the diagnosis in 17 patients. Other diagnostic possibilities are nasogastric intubation and the demonstration of the passage of air or contrast medium from the abdominal cavity to the pleural cavity. Special attention should be paid to patients receiving artificial ventilation, in whom the positive airway pressure may keep the viscera in their correct position.

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