Diaphragm injury

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  • 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

Differential Diagnosis

Thoracic Trauma


  • CXR may show visceral herniation
  • CT chest/abdomen/pelvis with contrast may better detect smaller herniations (roughly 82% sensitive and 88% specific) [1]
  • MRI better evaluates the diaphragm itself in stable patients in whom the diagnosis is unclear
  • Surgical exploration is ultimately the best diagnostic modality (thoracoscopy vs laparoscopy vs ex-lap depending on concurrent injuries)


  • Surgery is required to fix the defect


  • Admit

See Also


  1. Yucel, M et al. Evaluation of diaphragm in penetrating left thoracoabdominal stab injuries: The role of multislice computed tomography. Injury. 2015 Sep;46(9):1734-7.