The variable roentgen appearance of traumatic diaphragmatic hernia.

Alteration of the diaphragmatic contour should be added to the list of radiographic signs of traumatic diaphragmatic hernia (TDH). Such changes may sometimes be appreciated prior to gross herniation of abdominal viscera into the hemithorax. Alterations of the hemidiaphragmatic contour are non-specific, but suggestive of TDH in the appropriate clinical setting.