How to diagnose diaphragmatic injury

Diagnosis of diaphragmatic injury generally includes taking a medical history, symptom assessment, physical examination, imaging studies, and laboratory tests. The specific analysis is as follows:

1. Medical history: Focus on whether the patient has a history of chest or abdominal trauma, such as from motor vehicle accidents, falls from height, or penetrating injuries. Inquire about the time of injury, site of impact, and changes in symptoms following the injury to identify potential causes and establish a timeline, providing a foundation for further diagnosis.

2. Symptom assessment: Observe whether the patient experiences symptoms such as dyspnea, chest pain, cough, or hemoptysis. If severe injury leads to diaphragmatic rupture, additional symptoms like abdominal distension and nausea may occur. Symptoms help make an initial judgment about the location and severity of the injury and differentiate isolated diaphragmatic injury from injuries involving other organs.

3. Physical examination: Assess respiratory rate and rhythm for abnormalities; observe whether chest wall movement is symmetrical. Perform palpation to check for tenderness or rebound tenderness in the chest and abdomen. Auscultate breath sounds to determine if they are diminished or absent. In cases of diaphragmatic rupture, signs such as decreased breath sounds on the affected side and abdominal tenderness may be present, aiding in preliminary diagnosis.

4. Imaging studies: Commonly used modalities include chest X-ray and CT scans. X-rays can reveal abnormalities in the position and contour of the diaphragm, such as elevation or blurring of the diaphragmatic outline. CT provides clearer visualization of the extent of diaphragmatic injury and can detect complications such as diaphragmatic rupture or herniation of abdominal organs into the thoracic cavity.

5. Laboratory tests: Evaluate blood counts and arterial blood gas analysis. If infection accompanies the diaphragmatic injury, white blood cell count may be elevated. Blood gas analysis helps assess respiratory function and determine whether hypoxia or carbon dioxide retention has occurred due to impaired diaphragmatic function, providing guidance for treatment planning.

If diaphragmatic injury is suspected, relevant examinations should be completed promptly. Once the injury is confirmed, timely treatment must be initiated to prevent worsening and serious complications.