Better CT Scan Improves Detection of Penetrating Diaphragmatic Injury

Diaphragmatic injury occurs in as many as 20% to 40% of patients with penetrating trauma to the upper abdomen or low chest. Consequences of diaphragmatic injury can occur weeks to decades later, usually from herniation of bowel into the chest, and can cause considerable morbidity and mortality. Previous studies have demonstrated that conventional computed tomography (CT) has inadequate accuracy for the determination of diaphragmatic injury.

These authors reviewed 4-slice and 16-slice helical CT scans of consecutive patients with penetrating torso trauma who presented to a single trauma center from 2000 through 2004. Of 803 patients (64% stab wound, 36% gunshot wound) who underwent CT, 154 had surgical evaluation of the diaphragm. In this gro…