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June 1963

Rupture of the Diaphragm Due to Blunt Trauma

Author Affiliations

From the Department of Surgery, St. Louis University School of Medicine, Thoracic Surgical Service of St. Louis County Hospital, and the Surgical Service of St. Louis City Hospital.

Arch Surg. 1963;86(6):989-999. doi:10.1001/archsurg.1963.01310120107017

The recognition of a ruptured diaphragm following blunt trauma to the chest or abdomen is often delayed, in the absence of an external penetrating wound. A striking increase in recorded cases since World War II is, in a large part, due to high-velocity injuries brought about by an emphasis on faster transportation by modern automobiles. Diaphragmatic herniation caused by impact injury can no longer be regarded as infrequent. The literature concerning this subject is increasing, but the authors often include perforating injuries also.1-5

It is the purpose of this report to review 47 patients hospitalized during the past 12 years with diaphragmatic rupture, secondary to impact injury. We have not included lacerations or perforations due to gunshot wounds or stab wounds.

Material  Forty-seven patients hospitalized during the past 12 years with rupture of the diaphragm due to blunt trauma are studied (Table 1). In all but four instances an

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