Diaphragmatic slips

Last revised by Yuranga Weerakkody on 23 Jan 2023

Diaphragmatic slips are the muscular bundles that attach the central tendon of the diaphragm to the inside of the bones and cartilage of the lower 6-7 ribs, xiphoid process, lumbar vertebrae 1. They can mimic or help identify pathology when seen on imaging modalities.

Mimics

Diaphragmatic slips may simulate:

  • nodules/masses of the liver, lung bases, or upper peritoneum, particularly when viewed in one plane 1. Hyperinflation of the lungs or pneumoperitoneum can make the attachments of slips more pronounced.

  • lacerations: slips may form clefts in the liver or spleen, or sulci 2, that simulate laceration

Signs

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Cases and figures

  • Case 1: mimicking peritoneal implants
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  • Case 2
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  • Case 3: splenic cleft from diaphragmatic slip
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  • Case 4: with leaping dolphin sign
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