CTICasesDiaphragmatic Intramuscular Hematoma
Imaging findings
Contrast-enhanced CT following blunt trauma reveals a perisplenic hematoma, hemothorax, and multiple rib fractures. There is focal thickening of the adjacent left hemidiaphragm with sharp interfaces on both its pleural and peritoneal fat surfaces, without evidence of a diaphragmatic tear or herniation.
Key takeaways
Blunt trauma can cause isolated intramuscular hematomas within the diaphragm due to shearing forces or direct impact from adjacent fractured ribs. On CT, this presents as localized thickening of the diaphragmatic crura or muscle slip with well-defined interfaces and no herniation of abdominal contents. Recognition of this finding is important to differentiate it from a true diaphragmatic rupture, as diaphragmatic hematomas can be managed conservatively.
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