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Gastrointestinal
Diagnosis
Peritoneum, Mesentery, and Abdominal Wall
Trauma
Traumatic Diaphragmatic Rupture
Traumatic Diaphragmatic Rupture
Siva P. Raman, MD
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KEY FACTS

  • Imaging

    • Pathology

      • Clinical Issues

        TERMINOLOGY

        • Synonyms

          • Traumatic diaphragmatic hernia

        • Definitions

          • Diaphragmatic rupture ± herniation of abdominal contents into thorax

        IMAGING

        • General Features

          • CT Findings

            • MR Findings

              • Radiographic Findings

                • Fluoroscopic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Image Interpretation Pearls

                                  • Reporting Tips

                                    Selected References

                                    1. Abdellatif W et al: Unravelling the mysteries of traumatic diaphragmatic injury: an up-to-date review. Can Assoc Radiol J. 71(3):313-21, 2020
                                    2. Paes FM et al: Imaging evaluation of diaphragmatic injuries: improving interpretation accuracy. Eur J Radiol. 130:109134, 2020
                                    3. Dreizin D et al: Evolving concepts in MDCT diagnosis of penetrating diaphragmatic injury. Emerg Radiol. 22(2):149-56, 2014
                                    4. Panda A et al: Traumatic diaphragmatic injury: a review of CT signs and the difference between blunt and penetrating injury. Diagn Interv Radiol. 20(2):121-8, 2014
                                    5. Patlas MN et al: Diaphragmatic injuries: why do we struggle to detect them? Radiol Med. 120(1):12-20, 2014
                                    6. Sprunt JM et al: Computed tomography to diagnose blunt diaphragm injuries: not ready for prime time. Am Surg. 80(11):1124-7, 2014
                                    7. Dreizin D et al: Penetrating diaphragmatic injury: accuracy of 64-section multidetector CT with trajectography. Radiology. 268(3):729-37, 2013
                                    8. Desir A et al: CT of blunt diaphragmatic rupture. Radiographics. 32(2):477-98, 2012
                                    9. Kuo IM et al: Blunt diaphragmatic rupture--a rare but challenging entity in thoracoabdominal trauma. Am J Emerg Med. 30(6):919-24, 2012
                                    10. Dirican A et al: Acute traumatic diaphragmatic ruptures: a retrospective study of 48 cases. Surg Today. 41(10):1352-6, 2011
                                    11. Atri M et al: Surgically important bowel and/or mesenteric injury in blunt trauma: accuracy of multidetector CT for evaluation. Radiology. 249(2):524-33, 2008
                                    12. Stein DM et al: Accuracy of computed tomography (CT) scan in the detection of penetrating diaphragm injury. J Trauma. 63(3):538-43, 2007
                                    13. Rees O et al: Multidetector-row CT of right hemidiaphragmatic rupture caused by blunt trauma: a review of 12 cases. Clin Radiol. 60(12):1280-9, 2005
                                    14. Iochum S et al: Imaging of diaphragmatic injury: a diagnostic challenge? Radiographics. 22 Spec No:S103-16; discussion S116-8, 2002
                                    15. Larici AR et al: Helical CT with sagittal and coronal reconstructions: accuracy for detection of diaphragmatic injury. AJR Am J Roentgenol. 179(2):451-7, 2002
                                    16. Yao DC et al: Using contrast-enhanced helical CT to visualize arterial extravasation after blunt abdominal trauma: incidence and organ distribution. AJR Am J Roentgenol. 178(1):17-20, 2002
                                    17. Bergin D et al: The "dependent viscera" sign in CT diagnosis of blunt traumatic diaphragmatic rupture. AJR Am J Roentgenol. 177(5):1137-40, 2001
                                    18. Killeen KL et al: Helical CT of diaphragmatic rupture caused by blunt trauma. AJR Am J Roentgenol. 173(6):1611-6, 1999
                                    19. Shackleton KL et al: Traumatic diaphragmatic injuries: spectrum of radiographic findings. Radiographics. 18(1):49-59, 1998
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Imaging

                                      • Pathology

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Synonyms

                                            • Traumatic diaphragmatic hernia

                                          • Definitions

                                            • Diaphragmatic rupture ± herniation of abdominal contents into thorax

                                          IMAGING

                                          • General Features

                                            • CT Findings

                                              • MR Findings

                                                • Radiographic Findings

                                                  • Fluoroscopic Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Image Interpretation Pearls

                                                                    • Reporting Tips

                                                                      Selected References

                                                                      1. Abdellatif W et al: Unravelling the mysteries of traumatic diaphragmatic injury: an up-to-date review. Can Assoc Radiol J. 71(3):313-21, 2020
                                                                      2. Paes FM et al: Imaging evaluation of diaphragmatic injuries: improving interpretation accuracy. Eur J Radiol. 130:109134, 2020
                                                                      3. Dreizin D et al: Evolving concepts in MDCT diagnosis of penetrating diaphragmatic injury. Emerg Radiol. 22(2):149-56, 2014
                                                                      4. Panda A et al: Traumatic diaphragmatic injury: a review of CT signs and the difference between blunt and penetrating injury. Diagn Interv Radiol. 20(2):121-8, 2014
                                                                      5. Patlas MN et al: Diaphragmatic injuries: why do we struggle to detect them? Radiol Med. 120(1):12-20, 2014
                                                                      6. Sprunt JM et al: Computed tomography to diagnose blunt diaphragm injuries: not ready for prime time. Am Surg. 80(11):1124-7, 2014
                                                                      7. Dreizin D et al: Penetrating diaphragmatic injury: accuracy of 64-section multidetector CT with trajectography. Radiology. 268(3):729-37, 2013
                                                                      8. Desir A et al: CT of blunt diaphragmatic rupture. Radiographics. 32(2):477-98, 2012
                                                                      9. Kuo IM et al: Blunt diaphragmatic rupture--a rare but challenging entity in thoracoabdominal trauma. Am J Emerg Med. 30(6):919-24, 2012
                                                                      10. Dirican A et al: Acute traumatic diaphragmatic ruptures: a retrospective study of 48 cases. Surg Today. 41(10):1352-6, 2011
                                                                      11. Atri M et al: Surgically important bowel and/or mesenteric injury in blunt trauma: accuracy of multidetector CT for evaluation. Radiology. 249(2):524-33, 2008
                                                                      12. Stein DM et al: Accuracy of computed tomography (CT) scan in the detection of penetrating diaphragm injury. J Trauma. 63(3):538-43, 2007
                                                                      13. Rees O et al: Multidetector-row CT of right hemidiaphragmatic rupture caused by blunt trauma: a review of 12 cases. Clin Radiol. 60(12):1280-9, 2005
                                                                      14. Iochum S et al: Imaging of diaphragmatic injury: a diagnostic challenge? Radiographics. 22 Spec No:S103-16; discussion S116-8, 2002
                                                                      15. Larici AR et al: Helical CT with sagittal and coronal reconstructions: accuracy for detection of diaphragmatic injury. AJR Am J Roentgenol. 179(2):451-7, 2002
                                                                      16. Yao DC et al: Using contrast-enhanced helical CT to visualize arterial extravasation after blunt abdominal trauma: incidence and organ distribution. AJR Am J Roentgenol. 178(1):17-20, 2002
                                                                      17. Bergin D et al: The "dependent viscera" sign in CT diagnosis of blunt traumatic diaphragmatic rupture. AJR Am J Roentgenol. 177(5):1137-40, 2001
                                                                      18. Killeen KL et al: Helical CT of diaphragmatic rupture caused by blunt trauma. AJR Am J Roentgenol. 173(6):1611-6, 1999
                                                                      19. Shackleton KL et al: Traumatic diaphragmatic injuries: spectrum of radiographic findings. Radiographics. 18(1):49-59, 1998