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Traumatic Diaphragmatic Injuries

John Ramos1

  • 1Author Affiliations: Department of Emergency Medicine, Duke University Medical Center, Durham, North Carolina.

Advanced Emergency Nursing Journal
|December 10, 2025
PubMed

Insights

Traumatic diaphragmatic injuries (TDI) are rare but deadly, often missed initially. Early recognition and intervention are crucial for improving patient outcomes and reducing mortality from this serious condition.

Area of Science:

  • Trauma Surgery
  • Thoracic Surgery
  • Diagnostic Imaging

Background:

  • Diaphragmatic injuries are uncommon but linked to high mortality, especially with complications like strangulated bowel.
  • Traumatic diaphragmatic injury (TDI) is frequently underdiagnosed, leading to common delayed presentations.
  • Blunt TDI often accompanies severe injuries such as pneumothorax and hemorrhagic shock.

Purpose of the Study:

  • To highlight the critical importance of recognizing traumatic diaphragmatic injuries.
  • To emphasize the high mortality associated with delayed diagnosis and management of TDI.
  • To inform healthcare providers, including nurse practitioners and physician assistants, about TDI surveillance.

Main Methods:

  • Review of literature on traumatic diaphragmatic injuries.
  • Discussion of diagnostic modalities including contrast-enhanced computed tomography and laparoscopy.
  • Analysis of clinical presentation and management strategies for blunt and penetrating TDI.

Main Results:

  • Firearm injuries and stab wounds are the predominant causes of TDI.
  • Contrast-enhanced computed tomography is the gold standard for diagnosing TDI.
  • Laparoscopy serves as a valuable nonoperative diagnostic tool.

Conclusions:

  • Prompt recognition and management of TDI are essential to reduce mortality.
  • Delayed presentations of TDI are common and increase the risk of complications.
  • Healthcare providers need clear guidance on the surveillance of initially nonoperative diaphragmatic injuries.

Keywords:
bowel obstructiondiaphragm rupturediaphragm traumalaparoscopynonoperative management

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