Author details

Turkan Dubus

15. Traumatic diaphragm injuries

pneumothorax and right clavicle fracture.

108 Trauma Surgery

on the left side than on the right side [9, 39, 40].

ical movements [41, 42].

Traumatic diaphragm injuries may occur due to blunt or penetrating traumas of the thorax and abdomen. Of all diaphragm injuries, 75% are associated with blunt traumas, and 25% are due to penetrating traumas. Their incidence varies between 1 and 5%. The right diaphragm is protected against injuries by the liver, and so diaphragm ruptures are five times more common

Figure 5. PA chest radiography of a case operated on with a right tube thoracostomy due to a developed traumatic right

Conventional radiological investigations that can be performed when the patient is stabilized are the most important diagnostic methods. Diaphragm elevations, basal atelectasis, loss and/ or irregularity of diaphragm borders, blunting of the costophrenic sinus and abnormal nasogastric tube positioning are among the key findings in a direct lung radiography. Furthermore, a fluoroscopy can indicate whether or not the diaphragm is immobile, or can display paradox-

CT is also important for the identification of concomitant injuries, such as those to the liver, spleen or kidneys. The CT findings of a diaphragm injury include the interruption of diaphragm continuity, visualization of a defect in the diaphragm, herniation of the abdominal Address all correspondence to: drturkandbs@yahoo.com

Thoracic Surgery Department, Istanbul Training and Research Hospital, Health Sciences University, Istanbul, Turkey
