If a PA catheter is present equalization of pressures may be seen. Prompt drianage via pericardial window is the best treatment. This procedure may be performed with local anesthesia. Hemodynamic changes are minimized with the spontaneously breathing patient. The symptoms of diaphragmatic rupture are similar to pneumothrax as the lung is compressed and hypoxemia developes.
Diagnosis is made with the chest xray.
Loss of the diaphragmatic countour, presense of bowel or NG tube in the chest or elevaton of the right hemidiapragm are all suggestive. Intubation and mechanical ventilation are needed for adequate oxygenation. Can J Anaesth, 1993. Rosenthal, M.A. and J.I. Ellis, Cardiac and mediastinal trauma. Feghali, N.T. and L.M. Prisant, Blunt Myocardial Injury.