Ruptured hemidiaphragm

Case contributed by Melbourne Uni Radiology Masters
Diagnosis certain


Trauma. Post traumatic pneumatocele?

Patient Data

Age: 30 years
Gender: Female

Chest X-ray


Large left pleural effusion with mediastinal shift to the right. Gastric bubble in the left hemithorax.

The right lung and pleural space are clear. No displaced rib fractures.

CT Chest and Abdomen


Abdominal viscera lie with the left hemithorax in keeping with a ruptured diaphragm.

Case Discussion

The CT findings are in keeping with rupture of the left hemidiaphragm, confirmed and repaired at surgery.

Diaphragmatic rupture often results from blunt abdominal trauma, which is usually associated with motor-vehicle accidents and hence a predominance of young males.​

In major trauma, if the diaphragm cannot be identified one should have a high index of suspicion for possible rupture of the hemidiaphragm.

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