CTICasesTraumatic Diaphragmatic Hernia with Hepatic Herniation
Imaging findings
Initial CT shows a focal mass-like pulmonary contusion in the right lower lobe immediately following trauma. Years later, imaging reveals a large right basal hemithorax opacity with a convex upper interface, which coronal and axial CT reformats confirm to be hepatic herniation through a traumatic diaphragmatic rupture.
Key takeaways
Traumatic diaphragmatic rupture, particularly on the right side, can be clinically silent initially and present years later as progressive herniation of the liver into the chest. Recognizing the continuity of the liver through the diaphragmatic defect and the collar sign of the diaphragmatic constriction is crucial for diagnosis.
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