Diaphragmatic rupture pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathophysiology
Although the mechanism is unknown, it is proposed that a blow to the abdomen may raise the pressure within the abdomen so high that the diaphragm bursts. Blunt trauma creates a large pressure gradient between the abdominal and thoracic cavities; this gradient, in addition to causing the rupture, can also cause abdominal contents to herniate into the thoracic cavity. Abdominal contents in the pleural space interfere with breathing and cardiac activity. They can interfere with the return of blood to the heart and prevent the heart from filling effectively, reducing cardiac output. If ventilation of the lung on the side of the tear is severely inhibited, hypoxemia (low blood oxygen) results.
Usually the rupture is on the same side as an impact. A blow to the side is three times more likely to cause diaphragmatic rupture than a blow to the front.