Diaphragmatic rupture

Diaphragmatic rupture
An X-ray showing a raised diaphragm on the right[1]
Specialty	Cardiothoracic surgery
Symptoms	Difficulty breathing, chest pain
Causes	Trauma
Diagnostic method	Laparotomy, CT scan, X-ray
Treatment	Surgery
Prognosis	15–40% mortality rate

Diaphragmatic rupture (also called diaphragmatic injury or tear) is a tear of the diaphragm, the muscle across the bottom of the ribcage that plays a crucial role in breathing. Most commonly, acquired diaphragmatic tears result from physical trauma. Diaphragmatic rupture can result from blunt or penetrating trauma and occurs in about 0.5% of all people with trauma.^[2]

Diagnostic techniques include X-ray, computed tomography, and surgical techniques such as an explorative surgery. Diagnosis is often difficult because signs may not show up on X-ray, or signs that do show up appear similar to other conditions. Signs and symptoms include chest and abdominal pain, difficulty breathing, and decreased lung sounds. When a tear is discovered, surgery is needed to repair it.

Injuries to the diaphragm are usually accompanied by other injuries, and they indicate that more severe injury may have occurred. The outcome often depends more on associated injuries than on the diaphragmatic injury itself. Since the pressure is higher in the abdominal cavity than the chest cavity, rupture of the diaphragm is almost always associated with herniation of abdominal organs into the chest cavity, which is called a diaphragmatic hernia. This herniation can interfere with breathing.