[Indirect traumatic diaphragmatic ruptures after blunt abdominal or thoracic trauma]

Traumatic diaphragmatic rupture after blunt thoracic or abdominal trauma is an indicator of serious associated injuries, but is itself often occult. Its diagnosis is still a challenge. In 14 consecutive patients with diaphragmatic rupture we developed a strategy for diagnostic work-up and therapy of diaphragmatic disruption. Ultrasound showed a sensitivity of 89% versus 50 and 29% in chest X-ray and CT scan, respectively. Ultrasound of the diaphragm directly after admission and after stabilization of the trauma patient in order to find diaphragmatic disruption early is compulsory. Early treatment will avoid associated complications.