Which finding would confirm a diaphragmatic injury following trauma?

Which finding would confirm a diaphragmatic injury following trauma?

• A. Positive bowel sounds in the thoracic cavity
• B. Absent breath sounds
• C. Tracheal deviation
• D. Nasogastric tube coiled in thorax

Answer: (D)

In diaphragmatic injury after trauma, contents from the abdomen herniate into the chest. The most definitive sign is when a nasogastric tube, after placement, is seen to coil in the thoracic cavity rather than lie in the stomach. This directly shows the stomach has migrated through a torn diaphragm, confirming the injury. Other signs like bowel sounds in the chest or absent breath sounds can occur with herniation, but they are not as specific or definitive. Tracheal deviation can happen with other thoracic emergencies and isn’t diagnostic of diaphragmatic rupture.

In diaphragmatic injury after trauma, contents from the abdomen herniate into the chest. The most definitive sign is when a nasogastric tube, after placement, is seen to coil in the thoracic cavity rather than lie in the stomach. This directly shows the stomach has migrated through a torn diaphragm, confirming the injury.

Other signs like bowel sounds in the chest or absent breath sounds can occur with herniation, but they are not as specific or definitive. Tracheal deviation can happen with other thoracic emergencies and isn’t diagnostic of diaphragmatic rupture.