Justin Wayne Skweres MD, Abstract Co-Author: Nothing to Disclose

Arielle Dubose MD, Abstract Co-Author: Nothing to Disclose

Guillermo P. Sangster MD, Presenter: Nothing to Disclose

John Robinson MS, Abstract Co-Author: Nothing to Disclose

Jason Brownell, Abstract Co-Author: Nothing to Disclose

Maureen Gail Heldmann MD, Abstract Co-Author: Nothing to Disclose

1.Illustrate Multidetector Computed Tomography (MDCT) findings of diaphragmatic injury (DI) after blunt thoraco-abdominal trauma. 2.Depict direct and indirect signs of DI. 3.Discuss false positive findings that may be misinterpreted as DI at MDCT.  

MDCT is the imaging modality of choice for evaluation of hemodynamically stable patients with blunt trauma. DI is an uncommon but serious condition, and often unrecognized. A collective of patients with diaphragmatic rupture or detachment after blunt trauma encountered in clinical practice trauma center form the basis of this pictorial essay. Direct and indirect signs of DI are discussed: 1. Diaphragm discontinuity. 2. Intrathoracic herniation of abdominal contents. 3. Constriction of the herniated abdominal viscera: “collar sign”. 4. Visualization of the herniated viscera against the posterior chest wall: “dependent viscera sign”. 5. The delayed diaphragmatic rupture process is reviewed. 6. Mimics of DI: congenital diaphragmatic defects (Bochdalek and Morgagni), eventration and hiatal hernias. This educational exhibit substantiates the benefits of multiplanar MDCT in the detection and pre-operative planning in trauma pts sustaining DI. Subtle signs should be recognized for timely diagnosis, and familiarity with potential mimics is key to avoid unnecessary procedures.  

http://abstract.rsna.org/uploads/2014/14006707/14006707_23de.pdf

Skweres, J, Dubose, A, Sangster, G, Robinson, J, Brownell, J, Heldmann, M, Diaphragmatic Disruption: A Frequently Missed Injury after Blunt Thoraco-abdominal Trauma; Lessons from a Level I Trauma Center.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006707.html