Initial chest radiography (CXR) has been noted to have limited diagnostic sensitivity to detect @entity131 ( @entity131 ). A further confounding variable may be intubation and positive pressure ventilation which may prevent @entity3976 of abdominal organs until weaning is achieved. We sought to determine the impact of positive pressure ventilation on the sensitivity of the initial CXR to identify @entity131 as well as to document the incidence of late @entity3976 occurring as positive pressure ventilation is weaned. A retrospective chart review of 166 @entity1 over an 8-year period in whom diagnosis of @entity131 was made on the same admission was performed. Etiology was penetrating @entity130 in 91 (55%). Eighty-five (51%) @entity1 were intubated and ventilated with positive pressure before the initial chest radiograph. Diagnosis was made within 24 hours in 144 (87%) cases. The ability to correctly identify @entity131 by CXR was affected by whether or not the @entity1 was intubated (intubated 12% vs nonintubated 27%; P = 0.001), side (right 10% vs left 27%; p = 0.04), and injury size (> 5 cm 81% vs < or = 5 cm 3%, P = 0.02). Late diagnosis was made in 22 cases: eight during surgery, six because of persistent @entity854 , and six when high levels of ventilator support were decreased with subsequent @entity3976 of stomach above the diaphragm. Two cases were described at autopsy. @entity130 cannot be excluded if @entity1 are intubated. Late diagnosis can be facilitated if chest radiographs are reviewed in sequence as ventilator support is decreased.

The impact of positive pressure ventilation on the diagnosis of traumatic XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity131 :: ('MESH:D001930', 'Disease') :: ['ADI', 'acute diaphragmatic injury'] @entity3976 :: ('MESH:D004677', 'Disease') :: ['herniation'] @entity854 :: ('MESH:D018376', 'Disease') :: ['radiographic abnormalities'] @entity130 :: ('MESH:D014947', 'Disease') :: ['Diaphragmatic injuries', 'trauma']
@entity130 :: (MESH:D014947,Disease) :: ['diaphragmatic injury']
