Diaphragmatic Trauma
Diaphragmatic Trauma is a topic covered in the 5-Minute Emergency Consult.
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Basics
Description
Description
- Penetrating injury:
- Violation of the diaphragm by penetrating object (most commonly stab and gunshot wounds)
- May involve any portion of diaphragm
- Smaller defect compared with blunt injuries (more likely to be missed)
- Blunt injury:
- Increased intra-abdominal or intrathoracic pressure is transmitted to diaphragm, causing rupture.
- Usually due to motor vehicle crashes
- Injuries are more commonly left-sided:
- Left hemidiaphragm has posterolateral embryologic point of weakness.
- Right hemidiaphragm is protected by liver.
- Injuries are larger than with penetrating injury (frequently between 5 and 15 cm in length).
- Diaphragmatic defects do not heal spontaneously because of pleuroperitoneal pressure gradient:
- May exceed 100 cm H2O during maximal respiratory effort
- Promotes herniation of abdominal contents through rent in diaphragm and into chest
Epidemiology
Epidemiology
Incidence
Uncommon; <1% of all traumatic injuries
Etiology
Etiology
- Lateral torso impact is 3 times more likely to result in ipsilateral diaphragmatic rupture than frontal impact.
- Suspect diaphragmatic injury:
- Penetrating trauma to thoracoabdominal area
- Injuries that cross plane of the diaphragm
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Citation
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TY - ELEC
T1 - Diaphragmatic Trauma
ID - 307469
ED - Barkin,Adam Z,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Shayne,Philip,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307469/all/Diaphragmatic_Trauma
PB - Lippincott Williams & Wilkins
ET - 5
DB - Emergency Central
DP - Unbound Medicine
ER -