Median sternotomy: extension of laparotomy for ruptured right hemidiaphragm

A 21-year-old man sustained lacerations of spleen, liver, and right hemidiaphragm from blunt trauma. Exposure and repair of the liver and right hemidiaphragm were facilitated by sternal extension of a midline abdominal incision. This operative plan is recommended in severe torso trauma with suspicion of hepatic and/or diaphragmatic injury.