CTICasesLarge Traumatic Diaphragmatic Rupture with Dependent Viscera Sign
Imaging findings
In a severely injured patient ejected from a motor vehicle, chest imaging shows an abnormal diaphragmatic contour with pulmonary contusion, gastric fundus abutting the posterior chest wall, and colon herniated high into the thorax -- a striking example of the dependent viscera sign, with a 14 cm diaphragmatic defect so large that essentially no residual diaphragm is visible; the gastroesophageal junction is confirmed intact.
Key takeaways
The dependent viscera sign -- abdominal organs resting directly against the posterior chest wall without the normal diaphragmatic sling holding them up -- is a reliable indicator of diaphragmatic rupture, and very large defects can leave essentially no visible residual diaphragm, making the crura (rather than the diaphragm itself) the key landmark for confirming the gastroesophageal junction remains intact for surgical planning.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Cervicothoracic Sign Localizing a Substernal GoiterNeoplastic
- Azygos Continuation of the IVC with Bilateral Hyparterial Bronchi and Polysplenia-like AnatomyCongenital
- Extrapleural Fat Hyperplasia in Chronic Diffuse Pleural DiseaseArtifact
- Primary Pericardial MesotheliomaNeoplastic
- Tracheal Involvement of Granulomatosis with Polyangiitis (GPA)Autoimmune
- Multiple Cardiac Myxomas in Carney ComplexNeoplastic
- Constrictive Pericarditis with Circumferential Pericardial CalcificationInflammatory
- LVAD Outflow Graft Extraluminal Debris Causing Low-Flow AlarmsArtifact
See all cases from March 23, 2018 →