Diaphragmatic rupture causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Causes
The injury may be caused by blunt trauma, penetrating trauma, and by iatrogenic causes (as a result of medical intervention), for example during surgery to the abdomen or chest.[1] Injury to the diaphragm is reported to be present in 8% of cases of blunt chest trauma.[2] In cases of blunt trauma, vehicle accidents and falls are the most common causes.[1] Penetrating trauma has been reported to cause 12.3–20% of cases, but it has also been proposed as a more common cause than blunt trauma; discrepancies could be due to varying regional, social, and economic factors in the areas studied.[3] Stab and gunshot wounds can cause diaphragmatic injuries.[1] Clinicians are trained to suspect diaphragmatic rupture particularly if penetrating trauma has occurred to the lower chest or upper abdomen.[4] With penetrating trauma, the contents of the abdomen may not herniate into the chest cavity right away, but they may do so later, causing the presentation to be delayed.[1] Since the diaphragm moves up and down during breathing, penetrating trauma to various parts of the torso may injure the diaphragm; penetrating injuries as high as the third rib and as low as the twelfth have been found to injure the diaphragm.<ref name="Fleisher06">Fleisher GR, Ludwig S, Henretig FM, Ruddy RM, Silverman BK, ed. (2006). "Thoracic trauma". Textbook of Pediatric Emergency Medicine. Hagerstown, MD: Lippincott Williams & Wilkins. pp. 1446–7. ISBN 0-7817-5074-1.</ref