Traumatic diaphragmatic ruptures are comparatively rare and follow crush injuries to the chest or penetrating injuries such as stab wounds. Lacerations usually occur in the tendinous portion of the diaphragm, most often on the left hand side. The liver provides protection to blunt diaphragmatic injury on the right but does little to prevent penetrating wound damage.
Abdominal viscera may herniate immediately through the defect into the pleural cavity or may gradually insinuate themselves into the thorax over a period of months or years. The stomach is particularly prone to herniation on the left. Presentation may not occur until there is strangulation.
Treatment is by urgent surgical repair.
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