Problem of the Ruptured Diaphragm

A high index of suspicion on the part of the physician is the most important factor in diagnosing ruptured diaphragm. Clinical manifestations in this series vary from no symptoms to life-endangering problems immediately after the injury. The presence of extraneous shadows above the diaphragm, such as gas-containing or homogeneous areas, along with a shift of the mediastinal structures away from this side, is extremely suggestive of a ruptured diaphragm. Of 112 patients who received surgical treatment for a ruptured diaphragm, 78 incurred the injury in automobile accidents. Transthoracic repair of the ruptured diaphragm is recommended as early as the patient's condition permits.