Osmosis video - Rupture of diaphragm: Nursing

Rupture of the diaphragm is a condition in which the diaphragm, a sheet of muscle that separates the chest and abdominal cavities, tears or breaks. It is usually caused by penetrating trauma or blunt abdominal trauma, and risk factors include sustaining injuries such as gunshot wounds, stab wounds, falls, and being involved in a motor vehicle crash.

A ruptured diaphragm can cause serious medical complications and even death if it is not treated quickly. People with a ruptured diaphragm can present with shortness of breath, cough, chest pain, and respiratory distress, which presents as short, shallow, and rapid breathing, as well as decreased SpO2, but these manifestations may be masked by other injuries the client sustained.

Diagnosis is made based on history, physical exam, and imaging findings on chest X-ray as well as other imaging methods such as ultrasound or chest CT. Treatment depends on the severity, with small tears only requiring monitoring and large tears requiring surgical repair and chest tubes post-operatively. Management of care focuses on maintaining adequate oxygenation and ventilation.