Right diaphragmatic hernia secondary to trauma; with report of two cases.

With automobile accidents at high speed on the increase, some previously rare injuries are becoming more common. Rupture of the left diaphragm is fairly common. On the right, it has been believed rare. The diagnosis has often been missed for many years after the causative injury. Any suspicious x-ray film shadow at the base of the right lung field after injury such as those that occur in accidents of great impact should arouse the physician's suspicions. A mushroom-shaped mass on the lateral x-ray view is characteristic. Introduction of pneumoperitoneum may help in diagnosis. Only if the peritoneal and pleural cavities communicate will this procedure produce a pneumothorax. Surgical correction is indicated in all cases. This is best done through the chest. The right lobe of the liver usually must be reduced. In general the results are excellent.