Penetrating rupture of the diaphragm without visceral herniation: MDCT diagnosis

Lower rib fractures due to trauma are common and further imaging of the thorax is not normally performed unless there are suspected associated injuries or complications. We present the case of a female who following a fall presented to accident and emergency with left sided chest pain and multiple rib fractures. CT performed using multidetector CT allowed the detection of an unsuspected associated diaphragmatic laceration which was subsequently repaired by surgery. In similar patients there should be a low threshold for CT and the diaphragm should be closely examined with multiplanar views.