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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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.


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