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Diaphragmatic
rupture (Pathophysiology (Herniation of abdominal contents…
Diaphragmatic
rupture
Definition
Perforation of the diaphragm
often due to traumatic insult
resulting in abdominal contents
in the mediastinum
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Pathophysiology
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Doesn't heal spontaneously, needs surgery
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Clinical
presentation
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Loss of conciousness, coma
Diagnosis
Examination
External signs of trauma
Respiratory distress, reduced chest expansion,
tachynpnoea, cyanosis
Investigations
Bedside
Obs: low sats, high RR, high HR, low BP (if bleeding)
ECG: often tachyarrhythmia
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Imaging
CXR: abnormal/high hemi diaphragm,
bowel loops in chest
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Management
Initial ABCDE
Disability
GCS (may be low)
BM (glucose), temp
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Circulation
HR, BP
IV access and fluid resus
UO
Breathing
Sats, RR
High flow O2
ABG, CXR
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