Bedside emergency ultrasonographic diagnosis of diaphragmatic rupture in blunt abdominal trauma

Michael Blaivas, Larry Brannam, Michael L Hawkins, Matthew L Lyon, K. Sriram

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Abdominal injury from significant blunt trauma can include injury to bowel, kidneys, liver, and spleen. In approximately 5% of all injuries one of the diaphragms is ruptured. Diaphragmatic rupture may not be easily detected and this can lead to significant morbidity and even mortality. Rupture may be suggested on chest X-ray film especially with abnormal nasogastric tube location but the accuracy of this method is modest only. Abdominal computed tomography is not accurate and magnetic resonance imaging, although very sensitive and specific, is not feasible in most trauma situations. Surgeons have often resorted to exploratory laparotomy or laparoscopy to make the diagnosis. Although not typically part of the basic Focused Abdominal Sonography for Trauma (FAST) examination, ultrasonographic diagnosis of diaphragmatic rupture is possible with little added time to the examination. We present 3 cases of diaphragmatic rupture discovered shortly after the patients' arrival, on initial trauma evaluation with the FAST. A discussion of previous literature and ultrasound technique for diagnosis follows the cases.

Original languageEnglish (US)
Pages (from-to)601-604
Number of pages4
JournalAmerican Journal of Emergency Medicine
Volume22
Issue number7
DOIs
StatePublished - Nov 1 2004

Keywords

  • Emergency ultrasound
  • FAST
  • abdominal ultrasound
  • blunt abdominal trauma
  • diaphragmatic rupture
  • ultrasound

ASJC Scopus subject areas

  • Emergency Medicine

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