[Traumatic rupture of the diaphragm (author's transl)].

Traumatic rupture of the diaphragm is diagnosed during the acute stage in only 50% of the cases. The reasons for this failure are that in many of these cases clinical symptoms of damage to abdominal organs or of injuries to the limbs predominate. Traumatic rupture of the diaphragm is usually the result of an indirect trauma. Clinical signs of extensive prolapse of viscera into the thoracic cavity are: dyspnoea, tachycardia, cyanosis or intestinal sounds heard over the thorax during auscultation. Once the diagnosis has been established surgical repair should follow. During the acute stage laparotomy is preferable; thoracotomy is indicated during the chronic stage. Post-operative symptoms are: dyspnoea during exercise, pain in the affected half of the chest and roentgeno-kymographically demonstrable restrictions of movement in the ruptured side of the diaphragm.