Certain findings on a chest radiograph may help identify a patient with blunt rupture of the diaphragm. These findings can help identify a patient who may require additional imaging studies. The authors are from the Universities of Minnesota and Texas Southwestern.


Findings diagnostic for diaphragmatic rupture:

(1) viscera in thoracic cavity

(2) nasogastric tube in thoracic cavity (assuming fully inserted)

(3) marked elevated of the hemidiaphragm


Findings suspicious for a diaphragmatic rupture:

(1) hemothorax

(2) pneumothorax

(3) elevation of the hemidiaphragm

(4) obliteration of the hemidiaphragm

(5) chest tube in place (I assume this means that a blunt injury requiring a chest tube may be associated with rupture of the diaphragm)

(6) mediastinal shift

(7) volume loss


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