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Diagnosis of Diaphragmatic Rupture
Physical Examination (not accurate) No specific signs
Chest X-ray - Unreliable - Low sensitivity & specificity - Hemothorax or pneumothorax often present - Nasogastric tube sign (rare)
CT Scan - More accurate than X-ray - No definitive signs - Dangling diaphragm - Collar sign - Hump & Band signs - Diagnosis rate 31-43.5%
Laparotomy - Misses up to 15% - Often finds injury during other abdominal surgery
Thoracoscopy / Laparoscopy - More reliable - Useful for chronic hernia detection

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