Diaphragmatic rupture: CT findings in 11 patients

PURPOSE: To determine the signs of diaphragmatic rupture at computed tomography (CT) and the frequency of preoperative diagnosis with CT. MATERIALS AND METHODS: CT scans in 11 consecutive patients with surgically proved tears of the diaphragm due to blunt trauma were reviewed by two chest radiologists. The observers assessed the presence of discontinuity of the diaphragm, herniation of abdominal viscera or omentum, and waistlike constriction of the herniated stomach or bowel (collar sign). Hospital records were reviewed to confirm surgical findings and ascertain whether the diagnosis had been suggested at CT. RESULTS: In eight of 11 patients, rupture of the diaphragm was on the left, and in three it was on the right. In nine patients, diagnostic findings were identified retrospectively on CT scans; these included discontinuity of the diaphragm (n = 9), herniation of the abdominal organs or bowel (n = 7), and constriction of the stomach (n = 3). CONCLUSION: CT enables detection of most diaphragmatic tears due to blunt trauma.