Diaphragmatic Injury

                    Diaphragmatic injury is one cause of visceral herniation into the chest. A majority of hemidiaphragmatic ruptures occur on the left side. The most common site for rupture is at the diaphragmatic dome, and the least common is at the rib muscular insertions. A number of these posttraumatic diaphragmatic ruptures are not initially apparent; herniation increases in size with time, and thus delayed imaging is necessary
                   Some of these hernias are detected only months later. Intubation appears to hinder the detection of diaphragmatic rupture. Thus an initial chest radiograph or CT detects only about half of diaphragmatic ruptures. These hernias became clinically symptomatic from days to years after trauma, and either conventional chest radiographs or upper gastrointestinal studies are diagnostic. Strangulation of intestinal content has developed, including delayed gastric perforation into the pleural cavity.
                   A rare cause of diaphragmatic rupture is cardiopulmonary resuscitation. Computed tomography detection sensitivities for diaphragmatic rupture are disappointing, especially for right hemidiaphragmatic rupture, and are of limited use; keep in mind that detection rates vary with time after trauma. Diaphragmatic crura are not thickened in patients with an injured diaphragm; coronal and sagittal reconstructions are also of limited value in detecting subtle diaphragmatic injury. Computed tomography usually does not reveal diaphragmatic discontinuity even with thin sectioning (except in the rare diaphragmatic avulsion); rather, intestinal content not confined by the diaphragm but spilling into the thorax is diagnostic of a hernia, and in the appropriate clinical setting provides indirect evidence for diaphragmatic rupture. A waistlike intestinal constriction at the site of herniation is occasionally detected if rupture is limited in scope. These traumatic hernias need to be distinguished from congenital diaphragmatic hernias and from hernias through the esophageal hiatus.
                     Ultrasonography findings in patients with diaphragmatic rupture due to blunt trauma range from diaphragmatic disruption to a nonvisualized diaphragm. Occasionally detected is a diaphragm surrounded by fluid or abdominal content herniating through a diaphragmatic defect. Preliminary reports suggest that MRI is reliable in detecting diaphragmatic injury; coronal and sagittal MRI reveal the site of a diaphragmatic tear and detect abdominal visceral herniating into the thorax, but keep in mind the limitation on early detection, as discussed previously. Scintigraphy using intraperitoneally instilled Tc-99m–macroaggregated albumin (MAA) detects a diaphragmatic rupture but is rarely necessary. Arecdotal reports describe spontaneous diaphragmatic rupture.
image
This is radiology images Traumatic rupture of left hemidiaphragm. A scout view localizer prior to computed tomography (CT) reveals mediastinal shift to the right, partial left lung atelectasis and an elevated stomach.
image
This is radiology images of the Traumatic left hemidiaphragm rupture.A: Chest radiograph reveals gas and fluid at the left lung base.B: A barium study performed through a nasogastric tube identifies part of the stomach in the chest.This study was performed several hours after that in part A, and now considerably more abdominal content has herniated into the chest.

Artikel Terkait

Diaphragmatic Injury
4/ 5
Oleh

Berlangganan

Suka dengan artikel di atas? Silakan berlangganan gratis via email

This below all content of radiology information

Neuroradiology Musculoskeletal radiology MRI Musculoskeletal MRI Abnormal Mri Brain differential diagnosis Head Neck X-RAY Anatomy mnemonic CT Teleradiology Radiology News Radiology chest musculoskeletal salary pediatrics ultrasound ultrasound images job Brain tumour interventional radiology abdomen CT Abdomen with contrast DAMS Imaging radiology ramblings residency c nature pediatric radiology random ramblings xray Radiology Top basics body imaging guide procedure web 2.0 C T Chest X Ray Interpretation Teleradiology Providers head and neck radiology video Fun b cancer chest radiology salary 1 Apk Android CXR ORTHOPEDICS Sonographic Measurements Stroke Ultrasound Hepatitis dams md/ms coaching radiology business tuberculosis BRAIN Clinicoradiological series FETUS GI radiology Gastrointestinal x ray GenitoUrinary Radiology 4 Radiology Conferences Radiology Images Telemedicine Ultrasound in Emergencies dynamic MRI lifestyle mammography radiology links renal case spine 3 tesla MRI Dams clinicoradiological series Entrepreneur Gastrointestinal Tract Images Literature Liver abscess ultrasound MD/MS coaching Radiology 40 Radiology Imaging Radiology Journal Radiology PDF Radiology mcqs UPPER LIMPS Ultrasound Technique blog bone tumour cardiac CT career cerebral venous thrombosis chest xray d fracture gadolinium gastrointestinal genitourinary radiology hepatobiliary imaging lipoma medical blogs mri lower abdomen pelvis psychiatry radiation concern social networking technology training urogenital imaging weblog 3D CT Arachnoid cyst CT Cardiac Diploma Guid Equipment Cost FDA Fibrous dysplasia Interventional Ultrasound Guiding Biopsi MDCT MR Pancreas MRI Vertebrae MRI Vertebrae lumbal MRI contrast MRS RTA Radiology Teaching resource TB Hip TECHNIQUE Tech Thorax X Ray Upper Ext aiims ankle sprain bowel cancer brain abscess case study computers and radiology contrast ependymoma epidermoid facebook guest post internet journal of radiology iphone kienbock disease liver liver segments ct locum tenens mri abdomen multislice CT pericallosal lipoma plain film teaching files private practice radiology humour shoulder arthrogram shoulder dislocation small bowel social media trigeminal neuralgia tuberous sclerosis venous 3d printing 7 tesla MRI ACL reconstruction ACL tear ACLS AIIMS nov 2008 ALPSA lesion ANGIOGRAPHY ATFL B12 deficiency BLS BOLD Breast imaging Breast imaging Mammography CHF CT Paranasal CT Scanner Price CT angiography CT coronary angiography CT technology CV junction CXR teaching files Carcinoid Chest X Ray Contrast Agent Creutzfeldt-Jakob Disease Dams MD/ms Dams grand rounds Diffusion weighted imaging Dysmenorrhea E E World Award 2011 EYE Embolization Imaging Entrepreneurship FMG India FMGE FNH Focal liver lesions ultrasound Focal nodular hyperplasia GBM GI Gall bladder Glioblastoma multiforme Glomus jugulare HEAD HEART HRCT HSG Head injury ICA dissection IRIA 2011 IUGR IVC filter Iliotibial Band Friction Syndrome Job Info Kidney Cancer LV thrombus Leptomeningeal cyst MAMOGRAPHY MCI Screening MD MPPG MR mammography MR urography MRA MRCP MRI Cervical MRI update MRI/PET MRV Mesenteric ischemia Middle East respiratory syndrome coronavirus (MERS-CoV) Motor neuron disease NECK Normal Liver US Oncology trial PDF Radiology PM and R Physician PNS Partial anomalous pulmonary venous drainage Persistent trigeminal artery Pg entrance Physiatrist Physiatry Physician Assistant Plastic Surgery Price MRI Machines 2017 Pulmonology Pulvinar sign Radiology Price List Radiology Today Radiology Updates Radiology grandrounds Radiology images of GI Tract Renal Ultrasound Retinal Surgery Rheumatology Ryles tube SKULL Seizure Sellar Masses Sleep Medicine Sports Medicine Subdural hematoma Surgery TBM TRIANGULAR FIBROCARTILAGE COMPLEX Trauma Surgery URI Ultrasound HIV Umbilical vein Update Article Upper Extremity X Ray Urology Usmle VHL Vascular Surgery Veteran Affairs X Ray Head about accessory bone acute cerebillitis acute pancreatitis aiims may 2011 aipg ankle ankle fracture apple articular cartilage aspergilloma atherosclerosis avulsion injury awards bankart lesion basilar artery thrombosis bilateral phaeochromocytoma biopsy bipolar bohler's angle bone tumours brachial plexus brain tb brainstem stroke branchial cyst breast cancer screening buford complex business today calcaneal fracture calcium scoring canned reports carcinoma esophagus carcinoma stomach cardiac ct/pet cardiac pacemaker cardiogen 82 cardiothoracic imaging catrotid artery dissection cavernoma cervical lymphnode levels chest radiographic score chest radiographs choledocolithiasis classification cloud computing cochlear implant colloid cyst communication in radiology compare case concha bullosa congenital brain anomalies congenital heart disease coronary CT coronary artery disease corpus callosum agenesis craniopharyngioma cryptococcal meningitis ct abdomen and pelvis cystic renal disease dams usmle dams visual treat deep brain stimulator dengue dengue hemorrhagic fever developmental dysplasia devices diagnostic imaging dialysis diffusion MR imaging diffusion tensor imaging diffusion tractography digital radiography distal facial neuroma dsa duplication gall bladder echinococcus echocardiography ectopic kidney elearning elevated diaphragm epilepsy esop facial neuroma fibular osteosarcoma functional mri gastrointenstinal tuberculosis germinoma gifts glioma google google plus gun shot injury haemangioblastoma health 2.0 healthcare consultancy hemangiblastoma hemophilia hippocampus hirayama disease hydatid cyst hypercoagulable hypoxic ischemic encephalopathy indian conferences inferior rectus anomaly infrared interior tomography interstitial lung disease intramedullary metastates intramedullary tuberculomas ipad ipad 2 jacoud's arthropathy kernohan's notch knee kohler's disease krukenberg tumour laceration leber's optic atrophy liver transplant lung contusion lymphatics macros marchifava bingami disease mastoiditis maxillary sinus mucocele medial malleolus ossicle medial tibial stress syndrome medical writting medicare medicolegal aspects of teleradiology migraine mortality motor area mri knee mri lumbal msk penang course mucinous cystadenoma multicentric Glioblastoma multiforme mycotic pseudoaneurysm of superficial temporal artery nephrogenic systemic fibrosis nephrology neurosurgery meets nonradiologist oesophagus olecranon spur online medical games open access opercular syndrome opinion orbit os odontoideum os radiale externum osirix osteochondritis osteochondroma osteoid osteoma outsourcing radiology ovarian tumour parameniscal cyst paranasal sinuses parotid vascular mass patellar sleeve avulsion fracture patent ductus arteriosus patent foramen ovale patient information pelvic MRI pericardial fat phaeochromocytoma pharmaceutical writting pineal tumour placenta accreta placenta increta placental insufficiency pneumococcal pneumonia polycystic kidney disease portal Hypertension posterior circulation stroke power point presentation primary complex protected health information pseudobulbar palsy pseudomyxoma peritonei publications pulmonary edema pulmonary embolism pulmonary tuberculosis rabbit ear sign rad radiographic deterioration pattern radiography radiolo radiologist blogs radiology city radiology debate radiology images of spleen radiology intervensional radiology learning radiology search engine radiology spotter radiology spotters radiolopolis raditudes rathke cleft cyst renal imaging renal sinus tumour right sided aortic arch robot round cell tumour sacral agenesis scaphoid fracture schatzki ring scientific content screening search engine secondaries secondary ossification centres silicosis social radiology soft tissue chondroma solitary pulmonary nodule spectroscopy spinal arachnoid cyst spinal cord tumours spinal osteochondroma spine tumour spinoglenoid cyst sternal tuberculosis stress fracture sacrum stroke mri sub-acute combined degeneration subclavian pseudoaneurysm subependymal giant cell astrocytoma sumer sethi swyer-james syndrome syringomyelia tb teaching video teleradiolo teleradiology business models teleradproviders teleultrasound temporal bone fracture tendoachilles testicular tumour tethered cord. MRI tibial stress fracture total knee arthroplasty total shoulder replacment trachea. tracheal diverticulum tracheal stenosis tracheomalacia traumatic lung cyst triceps tear triquetral fracture tubercular abscess tuberculoma tuberculosis elbow ultrasound image of The segments of the liver umblical artery doppler uroradiology vascular malformation vasovist venous angioma ventriculitis video ct scan video mri viral encephalitis vitamin deficiency x ray Vertebrae