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Posttraumatic diaphragmatic herniation: CT findings in two children
1Mallinckrodt Institute of Radiology, St. Louis, MO 63110-1076, USA.
Insights
Traumatic diaphragmatic rupture in children is rare and diagnosis is often delayed. Computed tomography (CT) effectively visualizes visceral herniations and aids in diagnosing this critical injury.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
- Trauma Management
Background:
- Traumatic diaphragmatic rupture is an uncommon pediatric injury.
- Diagnosis is frequently delayed due to nonspecific clinical and radiological signs.
- Motor-vehicle accidents are the leading cause of acquired diaphragmatic hernias in children.
Observation:
- This report details the computed tomography (CT) findings in two pediatric cases of traumatic diaphragmatic rupture.
- One case involved hepatic herniation, and the other involved gastric herniation.
- CT imaging demonstrated visceral herniations through the ruptured diaphragm.
Findings:
- CT is crucial for visualizing the diaphragm and associated visceral herniations.
- CT can reveal indirect signs of diaphragmatic rupture when direct visualization is challenging.
- The study highlights CT's utility in diagnosing traumatic diaphragmatic injuries in children.
Implications:
- Early and accurate diagnosis of traumatic diaphragmatic rupture is essential for timely surgical intervention.
- CT imaging should be considered in pediatric patients with suspected diaphragmatic injuries following trauma.
- Improved diagnostic capabilities can lead to better patient outcomes in pediatric trauma cases.
Abstract:
Traumatic diaphragmatic hernia is a rare injury in children. The diagnosis is often delayed because of nonspecific clinical and radiologic findings. We report the CT findings in two children with visceral herniations, one hepatic and one gastric, resulting from traumatic rupture of the diaphragm. Motor-vehicle accidents are the most common cause of acquired diaphragmatic hernia in children [1]. Because it is rare and often overshadowed by associated injuries, the diagnosis of posttraumatic diaphragmatic rupture is often delayed [1, 2]. We show how CT can aid visualization of the diaphragm or reveal associated findings leading to the diagnosis of diaphragmatic rupture.