TY - JOUR
T1 - Unravelling the Mysteries of Traumatic Diaphragmatic Injury
T2 - An Up-to-Date Review
AU - Abdellatif, Waleed
AU - Chow, Brandon
AU - Hamid, Saira
AU - Khorshed, Dina
AU - Khosa, Faisal
AU - Nicolaou, Savvas
AU - Murray, Nicolas
N1 - Funding Information:
Dr Faisal Khosa is the recipient of the Canadian Association of Radiologists/Canadian Radiological Foundation Leadership Scholarship (2017) and Vancouver Coastal Health Leadership Award. Dr Savvas Nicolaou and the University of British Columbia have a master research agreement with Siemens healthcare. All authors meet the full requirements to be considered as coauthors. All authors gave final approval to the submitted article and agree to be accountable for all aspects of the work. The study fully complies with ethical standards. Earlier version of this article was presented as educational poster in RSNA 2019 in Chicago, IL, USA. Content from this study was used to present a radiology grand round at University of British Columbia on Dec 18, 2019.
Publisher Copyright:
© The Author(s) 2020.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Traumatic diaphragmatic injury (TDI) is an underdiagnosed condition that has recently increased in prevalence due to its association with automobile collisions. The initial injury is often obscured by concurrent thoracic and abdominal injuries. Traumatic diaphragmatic injury itself is rarely lethal at initial presentation, however associated injuries and complications of untreated TDI such as herniation and strangulation of abdominal viscera have serious clinical consequences. There are 2 primary mechanisms of TDIs: penetrating TDI which tend to be smaller, more difficult to detect, and result in fewer complications; and blunt TDIs which are larger and have higher overall mortality due to associated injuries or delayed complications. The anatomy of thoracic and abdominal cavities distinguishes the epidemiology, pathophysiology, symptoms, treatment, and prognosis of right versus left TDI. Although there is no definitive radiologic sign for diagnosing TDI, many signs have been introduced in the literature and the concurrent presence of multiple signs increases the sensitivity of TDI detection. Conservative versus surgical management depends on mechanism of TDI, side, and most importantly the associated injuries.
AB - Traumatic diaphragmatic injury (TDI) is an underdiagnosed condition that has recently increased in prevalence due to its association with automobile collisions. The initial injury is often obscured by concurrent thoracic and abdominal injuries. Traumatic diaphragmatic injury itself is rarely lethal at initial presentation, however associated injuries and complications of untreated TDI such as herniation and strangulation of abdominal viscera have serious clinical consequences. There are 2 primary mechanisms of TDIs: penetrating TDI which tend to be smaller, more difficult to detect, and result in fewer complications; and blunt TDIs which are larger and have higher overall mortality due to associated injuries or delayed complications. The anatomy of thoracic and abdominal cavities distinguishes the epidemiology, pathophysiology, symptoms, treatment, and prognosis of right versus left TDI. Although there is no definitive radiologic sign for diagnosing TDI, many signs have been introduced in the literature and the concurrent presence of multiple signs increases the sensitivity of TDI detection. Conservative versus surgical management depends on mechanism of TDI, side, and most importantly the associated injuries.
KW - blunt trauma
KW - cinematic rendering
KW - diaphragmatic injury
KW - diaphragmatic tear
KW - emergency radiology
KW - postmortem CT
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U2 - 10.1177/0846537120905133
DO - 10.1177/0846537120905133
M3 - Article
C2 - 32157897
AN - SCOPUS:85083053016
SN - 0846-5371
VL - 71
SP - 313
EP - 321
JO - Canadian Association of Radiologists Journal
JF - Canadian Association of Radiologists Journal
IS - 3
ER -