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Diaphragmatic Injuries Follow-up

  • Author: Michelle Welsford, MD, FACEP, FRCPC(Canada); Chief Editor: Trevor John Mills, MD, MPH  more...
Updated: Oct 08, 2015


Early deaths usually are a result of associated injuries not the diaphragmatic tear. Mortality rate ranges from 5-30%.

Serious morbidity usually is related to reexpansion pulmonary edema or to the laparotomy.

Paralysis or incoordination of the diaphragm is common, but more than 50% of these conditions resolve.

The late complications of an undiagnosed traumatic hernia include all of the following: bowel herniation, incarceration, and strangulation; tension hemothorax secondary to massive bowel herniation; pericardial tamponade from herniation into the pericardial sac; and diaphragmatic paralysis that may recover after repair.

Death and significant morbidity rarely are related to delayed diagnosis. However, incarceration of herniated abdominal contents can lead to infarction or rupture with disastrous consequences.



The prognosis is generally good with immediate repair.

Contributor Information and Disclosures

Michelle Welsford, MD, FACEP, FRCPC(Canada) Associate Professor, Division of Emergency Medicine, Department of Medicine, McMaster University School of Medicine; Staff Emergency Physician, Hamilton Health Sciences; Medical Director, Centre for Paramedic Education and Research

Michelle Welsford, MD, FACEP, FRCPC(Canada) is a member of the following medical societies: American College of Emergency Physicians, American Heart Association, Ontario Medical Association, Canadian Association of Emergency Physicians, Canadian Medical Association, National Association of EMS Physicians, Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

David B Levy, DO, FAAEM Senior Consultant in Emergency Medicine, Waikato District Health Board, New Zealand; Associate Professor of Emergency Medicine, Northeastern Ohio Universities College of Medicine

David B Levy, DO, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, Fellowship of the Australasian College for Emergency Medicine, American Medical Informatics Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Steven A Conrad, MD, PhD Chief, Department of Emergency Medicine; Chief, Multidisciplinary Critical Care Service, Professor, Department of Emergency and Internal Medicine, Louisiana State University Health Sciences Center

Steven A Conrad, MD, PhD is a member of the following medical societies: American College of Chest Physicians, American College of Critical Care Medicine, American College of Emergency Physicians, American College of Physicians, International Society for Heart and Lung Transplantation, Louisiana State Medical Society, Shock Society, Society for Academic Emergency Medicine, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

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