The diaphragm. A caveat in the selective management of penetrating abdominal trauma

Summaries of two patients who were not operated upon because they seemed to have only minor upper abdominal stab wounds are presented. Both patients later developed symptomatic diaphragmatic hernias for which operation was required. These patients illustrate a shortcoming of the selective method of management of upper abdominal stab wounds and suggest that diagnostic paracentesis and peritoneal lavage should be employed regularly in patients who do not have a clear indication for laparotomy.