Traumatic rupture of the diaphragm and herniation of the liver

Abstract

Injuries that result in a sudden increase in intra-abdominal pressure may cause a diaphragmatic tear and visceral herniation. Right-sided tears are significantly less likely than left-sided tears because of the protective effect of the liver. When diaphragmatic elevation persists in a post-trauma patient, or if unexplained acidosis or hypoxemia develops, herniation of abdominal contents should be suspected. This is particularly true when other signs of severe trauma are present, such as multiple rib fractures, laceration of the liver or spleen, or a history of deceleration injury.