DIAPHRAGM TRAUMA

Course overview

THE DIAGNOSIS OF TRAUMATIC DIAPHRAGM INJURIES (TDI) CAN BE DIFFICULT BUT IS CRITICAL, AS A DELAYED DIAGNOSIS CAN CARRY SIGNIFICANT SEQUELAE. TDIS CAN OCCUR WITH BOTH PENETRATING AND BLUNT TRAUMA AND ARE OFTEN OCCULT. PATIENTS MAY VARY IN THEIR PRESENTATION BASED ON THE EXTENT AND LOCATION OF INJURY (RIGHT VERSUS LEFT HEMIDIAPHRAGM), THE PRESENCE AND EXTENT OF ABDOMINAL VISCERA DISPLACEMENT, AND THE PRESENCE OF OTHER INJURIES. FOR THIS REASON, THE MECHANISM OF INJURY (MOI) PLAYS A CRUCIAL ROLE IN ESTABLISHING A HIGH INDEX OF SUSPICION FOR DIAPHRAGMATIC INJURIES. THE FIRST REPORT OF DIAPHRAGM HERNIATION WAS DESCRIBED IN 1541, BUT IT WASN'T UNTIL A FEW CENTURIES LATER, IN 1853, THAT BOWDITCH DIAGNOSED THE FIRST ANTEMORTEM DIAPHRAGMATIC INJURY SECONDARY TO TRAUMA. THIS ACTIVITY REVIEWS THE EVALUATION AND MANAGEMENT OF TRAUMATIC DIAPHRAGM INJURIES AND HIGHLIGHTS THE ROLE OF THE TRAUMA TEAM, RADIOLOGISTS, AND SUBSPECIALTIES IN EVALUATING AND MANAGING PATIENTS WITH THIS CONDITION.