CASE 553 Published on 24.10.2000

Blunt left diaphragmatic rupture with stomach herniation

Section

Chest imaging

Case Type

Clinical Cases

Authors

M. Wintermark, P. Schnyder

Patient

62 years, female

Categories
No Area of Interest ; Imaging Technique CT
Clinical History
High-speed car accident
Imaging Findings
Unbelted 62-year-old female car driver involved in a high-speed traffic accident
Discussion
Clinical series report a predominance of left diaphragmatic ruptures (90%), whereas autopsy series show nearly equal prevalence of left- and right-sided diaphragmatic lesions. Indeed, because of the presence of the liver, right diaphragmatic ruptures are more difficult to diagnose clinically and radiologically. Furthermore, left diaphragmatic ruptures are more likely to occur because of the diaphragmatic anatomy and the biomechanics of trauma. The only unprotected diaphragmatic portion, where ruptures most often lie, relates to the postero-lateral aspect of the left diaphragmatic dome, at the junction of the peripheral muscular portion and the central tendon. The other diaphragmatic areas are supported above and below by adjacent organs: the right diaphragm is protected by the liver, which acts as a shock absorber, whereas the posterior portions are shielded by the kidneys and lumbar muscles and the central tendinous portion by the heart.
Differential Diagnosis List
Blunt left diaphragmatic rupture with stomach herniation
Final Diagnosis
Blunt left diaphragmatic rupture with stomach herniation
Case information
URL: https://www.eurorad.org/case/553
DOI: 10.1594/EURORAD/CASE.553
ISSN: 1563-4086