Diaphragmatic trauma: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==") |
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==Background== | ==Background== | ||
*Associated with penetrating trauma to lower chest/upper abdomen | *Associated with penetrating or blunt trauma to lower chest/upper abdomen | ||
*If missed, can lead to herniation of viscera and tension enterothorax | |||
*If missed can lead to herniation of viscera and | |||
*Most commonly left sided | *Most commonly left sided | ||
*Majority will have other injuries which can mask symptoms of diaphragm injury | |||
==Clinical Features== | ==Clinical Features== | ||
* | *Pain | ||
*Shortness of breath | |||
*Diminished breath sounds on side of rupture | *Diminished breath sounds on side of rupture | ||
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==Evaluation== | ==Evaluation== | ||
*CT | *CXR may show visceral herniation | ||
* | *CT chest/abdomen/pelvis with contrast may better detect smaller herniations (but not 100% sensitive) | ||
* | *MRI better evaluates the diaphragm itself in stable patients in whom the diagnosis is unclear | ||
*Surgical exploration is ultimately the best diagnostic modality | |||
==Management== | ==Management== | ||
*Surgery is required to fix the defect | |||
==Disposition== | ==Disposition== | ||
Revision as of 08:33, 1 January 2017
Background
- Associated with penetrating or blunt trauma to lower chest/upper abdomen
- If missed, can lead to herniation of viscera and tension enterothorax
- Most commonly left sided
- Majority will have other injuries which can mask symptoms of diaphragm injury
Clinical Features
- Pain
- Shortness of breath
- Diminished breath sounds on side of rupture
Differential Diagnosis
Thoracic Trauma
- Airway/Pulmonary
- Cardiac/Vascular
- Musculoskeletal
- Other
Evaluation
- CXR may show visceral herniation
- CT chest/abdomen/pelvis with contrast may better detect smaller herniations (but not 100% sensitive)
- MRI better evaluates the diaphragm itself in stable patients in whom the diagnosis is unclear
- Surgical exploration is ultimately the best diagnostic modality
Management
- Surgery is required to fix the defect
Disposition
- Admit