2. AIM
• To study the imaging findings of
traumatic diaphragmatic rupture using
CT as primary modality of choice.
CASE DETAILS
• We reported 2 cases of road traffic accidents
aged between 20-30 years having
breathlessess and abdominal pain.
• CT chest and abdomen revealed rupture of
diaphragm on left side with herniation of
stomach.
3. INTRODUCTION
• Diaphragmatic injuries are estimated to occur in 0.8-
8% of patients with blunt abdominal trauma.
• Blunt diaphragmatic rupture remains undiagnosed
at initial presentation in 7-66% of cases. Blunt
diaphragmatic injuries most often occur in vehicular
impact (90% of cases), a fall from a height or
crushing blow.75% of cases were caused blunt
trauma, 25% caused by penetrating trauma.90-98%
occur on left side.
• Multi detector CT is considered to be the reference
standard for the diagnosis of diaphragmatic injuries
4. Scout image showing indistinct
left hemidiaphragm with
radioluscent lesion filling left
hemithorax with displacement of
mediastinum to the right
Ct image(coronal) in the same
patient showing herniation of
stomach into left hemithorax
stomach
CASE 1
5. Coronal and sagittal image with oral contrast
in another patient reveals herniation of
stomach through the defect in diaphragm
after trauma with collapse of left lower lobe
CASE 2
6. CONCLUSION
• Traumatic diaphragmatic hernia has always been a diagnostic
challenge to both the radiologist and surgeon.More than 90%
of blunt traumatic ruptures result from motor vehicle
accidents,as was the case in above two cases.
• CT plays a key role to evaluate the diaphragm after trauma.
REFERENCES
• Iochum S, Ludig T, Walter F, et al. Imaging of diaphragmatic injury: a
diagnostic challenge? Radiographics. 2002;22:(Suppl)S103-
16.Sangster GP, González-Beicos A, Carbo AI, et al; Blunt traumatic
injuries of the lung parenchyma, pleura, thoracic wall, and
intrathoracic airways: multidetector computer tomography imaging
findings. Emerg Radiol. 2007;14:297-310. Al-Refaie RE, Awad E,
Mokbel EM; Blunt traumatic diaphragmatic rupture: a retrospective
observational study of 46 patients. Interact Cardiovasc Thorac
Surg. 2009;9:45-9.
