[Diagnosis and treatment of blunt injury to the diaphragm (author's transl)].

Blunt injuries to the diaphragm are rare. They usually occur in combination with injuries to other structures (craniocerebral trauma, fracture of the pelvis, rupture of the spleen or liver). Regarding the diagnosis, knowledge of the mechanism of the accident may point to the possibility of a ruptured diaphragm, and so may auscultation and percussion of the chest. Examination of the gastrointestinal tract and contrast enema may show up displacement of abdominal viscera into the left pleural cavity. In cases of rupture of the right diaphragm coeliacography and scintillation scanning are indicated. As regards treatment: every rupture of the diaphragm needs surgical repair. If prolapse of viscera has been established, prompt intervention is necessary because of the risk of acute incarceration. Asymptomatic prolapse causing only minor complaints should also be rectified to obviate complications. The best approach for both early and late repair of the diaphragm is via the thorax.