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Special Feature
August 2002

Image of the Month

Author Affiliations

From the Department of Surgery, University of Texas Medical Branch, Galveston.



Arch Surg. 2002;137(8):971. doi:

A 54-YEAR-OLD restrained driver was involved in a rollover motor vehicle crash and came to the emergency department complaining of shortness of breath, left pleuritic chest pain, and back pain. Her vital signs included the following: heart rate, 73 beats/min; blood pressure, 172/102 mm Hg; and respirations, 18/min. Although the patient's breath sounds were decreased on the left side, her oxygen saturation was 95% using a 100% oxygen non–rebreather face mask. The patient's chest x-ray film is shown in Figure 1.

What Is the Diagnosis?


B.Hiatal hernia

C.Diaphragmatic rupture

D.Pulmonary contusion.