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Rupture of the diaphragm

Christiansen, L. A., Stage, P., Bille Brahe, E., and Bertelsen, S. (1974).Thorax, 29, 559-563. Rupture of the diaphragm. A 23-year series of 25 patients with rupture of the diaphragm is presented. Symptoms, diagnostic procedures, and treatment are mentioned. A high index of suspicion of the diagnosis of ruptured diaphragm is most important in patients with a history of trauma. Familiarity with the signs on the plain chest film is important. Furthermore, we advocate an additional examination, that is diagnostic pneumoperitoneum, in all cases of suspected rupture of the diaphragm. If doubt still exists, we consider the final diagnostic procedure of choice to be exploratory thoracotomy until proof of the complete reliability of diagnostic pneumoperitoneum has been established.