clinical features
Last reviewed 01/2018
The clinical features of a traumatic diaphragmatic rupture vary according to the amount of viscera that herniates into the thorax. There may be some degree of intestinal obstruction:
- plain X-ray may show a solid mass if the primary herniated structure is the omentum or may reveal several fluid levels if hollow viscera herniate
- the passage of a nasogastric tube into a herniated stomach is diagnostic
- fluroscopic studies may reveal the stomach protruding through a diaphragmatic defect
- barium study of the colon may show irregular patches of barium in the colon above the diaphragm, or a smooth colonic outline if there are no faeces in the colon
Haemorrhage and obstruction are important complications. If the herniation is massive, progressive cardiorespiratory insufficiency may threaten life.