Diaphragmatic Injuries

  • Victor J. Sorensen


The diaphragm is a musculo-aponeurotic apron that divides the thoracic and abdominal cavities. The diaphragm’s internal attachments extend from the sternum anteriorly to the first three lumbar vertebrae posteriorly. The lateral attachments of the diaphragm extend from ribs six through twelve in an anterior to posterior orientation as well. The blood supply to the diaphragm derives from pericardiophrenic arteries, as well as multiple branches from both the abdominal aorta and intercostals. The phrenic nerves, which arise from the third, fourth and fifth cervical roots are responsible for the diaphragm’s innervation. The diaphragm normally contains three openings for important visceral structures. These include the inferior vena cava at the eighth thoracic vertebral level, the esophageal hiatus at the tenth level, and the aortic hiatus at the twelfth. The esophagus is accompanied by both right and left vagii and the aorta is accompanied by the thoracic duct and the azygous vein.


Blunt Chest Trauma Esophageal Hiatus Diaphragmatic Injury Portable Chest Azygous Vein 
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Selected References

  1. Asensio JA, Demetriades D, Rodriguez A: Injury to the diaphragm. In Feliciano DV, Moore EE,Mattox KL: Trauma, ed 3, Stanford CT, 1996, Appleton and Lange.Google Scholar
  2. Bender JS, Lucas CE: Management of Close Range Shotgun Injuries to the Chest by DiaphragmaticTransposition: Case Reports. J Trauma 30:1581–1584, 1990.PubMedCrossRefGoogle Scholar
  3. Chen JC, Wilson SE: Diaphragmatic Injuries: Recognition and Management in 62 Patients. Am Surg 57:810–815, 1991.PubMedGoogle Scholar
  4. Lindsey I, Woods SD, Nottle PD: Laparoscopic Management of Blunt Diaphragmatic Injury. Aust N.Z. J Surg 67:619–621, 1997.PubMedCrossRefGoogle Scholar
  5. Moore FE, Malangoni MAA, Cogbill T, et al: Organ Injury Scaling IV: Thoracic, Vascular, Lung,and Diaphragm, J Trauma 36:299–301, 1994.PubMedCrossRefGoogle Scholar
  6. Rosati C: Acute Traumatic Injury of the Diaphragm. Chest Surg Clinics North America 8:371–379, 1998.Google Scholar
  7. Trupha A, Waydhas C, Hallfeldt KK, et al: Value of Thoracic Topography in the First Assessmentof Severely Injured Patients with Blunt Chest Trauma Results of a Prospective Study.J Trauma 43:405–412, 1997.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Victor J. Sorensen

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