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May 4, 1979

Isolated Rupture of the Right Hemidiaphragm With Eventration of the Liver

Author Affiliations

From the Department of Surgery, University of Arizona Health Sciences Center, Tucson.

JAMA. 1979;241(18):1929-1930. doi:10.1001/jama.1979.03290440051031

DIAPHRAGMATIC rupture secondary to blunt trauma has been estimated to occur in approximately 4.5% of patients with several injuries. Lacerations of the left diaphragm are ten to 20 times more common than those on the right side; the difference is often attributed to the protection afforded the right hemidiaphragm by the dome of the right lobe of the liver.1 Most series report a high incidence of associated injuries,1,2 notably to the pelvis, spine, brain, and extremities, as well as to the intraabdominal organs. Early diagnosis is often delayed because of the extent of the associated injuries or because of a low index of suspicion. In the acute phase, the diagnosis of rupture of the right hemidiaphragm can be more difficult, as herniation of the liver may often be mistaken for merely an elevated intact diaphragm. We report a case of isolated rupture of the right hemidiaphragm secondary to