Diaphragmatic rupture: CT findings in 11 patients.
OBJECTIVE
To determine the signs of diaphragmatic rupture at computed tomography (CT) and the frequency of preoperative diagnosis with CT.


METHODS
CT scans in 11 consecutive patients with surgically proved tears of the diaphragm due to blunt trauma were reviewed by two chest radiologists. The observers assessed the presence of discontinuity of the diaphragm, herniation of abdominal viscera or omentum, and waistlike constriction of the herniated stomach or bowel (collar sign). Hospital records were reviewed to confirm surgical findings and ascertain whether the diagnosis has been suggested at CT.


RESULTS
In eight of 11 patients, rupture of the diaphragm was on the left, and in three it was on the right. In nine patients, diagnostic findings were identified retrospectively on CT scans; these included discontinuity of the diaphragm (n = 9), herniation of the abdominal organs or bowel (n = 7), and constriction of the stomach (n = 3).


CONCLUSIONS
CT enables detection of most diaphragmatic tears due to blunt trauma.
Worthy
S A
SA
Department of Radiology, Vancouver Hospital and Health Sciences Center, BC, Canada.
Kang
E Y
EY
Hartman
T E
TE
Kwong
J S
JS
Mayo
J R
JR
Müller
N L
NL
D000328:Adult; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000293:injuries*; D006549:Hernia, Diaphragmatic, Traumatic / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011300:Preoperative Care; D012189:Retrospective Studies; D012421:Rupture; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging*