Grey scale ultrasonic demonstration of ruptured right hemidiaphragm.

Traumatic rupture of the diaphragm is a relatively infrequent but important clinical entity. It is usually secondary to blunt trauma of the lower chest and/or upper abdomen, such as compression of the trunk by a steering wheel in a motor vehicle accident. Less frequently it may be due to a penetrating injury or other aetiologies. We recently encountered a patient who presented to us 12 years after injury. This is the first known reported case to be diagnosed by ultrasound in addition to other conventional studies. A 47-year-old white male was admitted on February 16, 1979 with shortness of breath of three to four years, getting worse over the last few months. He also complained of right-sided and precordial chest pain increasing over the last few months. The patient gave a past history of having been involved in an automobile accident in 1967. Physical examination revealed small scars on the right lower chest and decreased breath sounds in the right lung base, but was otherwise unremarkable. Initial haema...