diaphragmatic rupture

Continuity disruption

Record whether a tear is demonstrated, inferred or unresolved, including evidence against congenital defects, eventration and isolated hiatal disease.

1. What observation establishes an acquired break in diaphragm continuity? definition
2. Could the finding instead represent an intact elevated diaphragm, a congenital defect or an enlarged normal hiatus? boundary

Injury and recognition sequence

Maintain separate dates and confidence for the causative event, first symptoms, first suspicious evidence and confirmation.

1. Which documented event or procedure is linked to the tear, and how certain is that attribution? provenance
2. What interval separates the suspected injury from recognition, and which dates are estimates? measurement

Defect map

Record side, anatomical region, dimensions, number of defects and observed tissue loss, retaining differences between imaging and operative observations.

1. Where is each tear, and what are its measured dimensions and tissue-loss features? measurement
2. Were these details observed on imaging or during an operation, and were any diaphragm regions unassessed? provenance

Displaced viscera status

Identify any contents traversing the defect and separately document evidence of entrapment, obstruction, impaired perfusion or perforation.

1. Which organs traverse the tear, and is herniation absent, present or indeterminate? measurement
2. What evidence supports or excludes obstruction, impaired perfusion or perforation of those organs? measurement

Residual diagnostic uncertainty

Record examination findings, technical limitations and remaining suspicion. Diagnostic strategy depends on injury context; the EAST guideline specifically evaluates laparoscopy versus CT for stable left thoracoabdominal stab wounds. [EAST guideline](https://www.east.org/education-resources/practice-management-guidelines/details/diaphragmatic-injury-evaluation-and-management-of).

1. What did each examination demonstrate, and what limited assessment of diaphragm continuity? provenance
2. If suspicion remains, what further assessment has the responsible clinician selected and why? action

Rupture-related deterioration

Link timed physiological observations to possible mechanical or visceral consequences without automatically attributing all trauma-related instability to the diaphragm.

1. How have oxygenation, ventilation and haemodynamic observations changed alongside the anatomical findings? measurement
2. Which effects are attributed to the rupture, and which may arise from associated injuries? boundary

Individualised management decision

Record how mechanism, side, stability, associated injuries and presentation timing informed management. EAST's recommendations are conditional and supported by very low-quality evidence, so guideline applicability and uncertainty must remain explicit. [EAST guideline](https://www.east.org/education-resources/practice-management-guidelines/details/diaphragmatic-injury-evaluation-and-management-of).

1. What management did the responsible team choose, and which patient-specific findings and guideline population support it? action
2. If definitive treatment is deferred, what reason, reassessment plan and escalation criteria are documented? action

Closure and subsequent defect status

Link the operative account of closure and any prosthetic material to subsequent evidence of integrity, residual discontinuity, recurrent herniation and persistent symptoms.

1. What documents the completed repair, including defect coverage, tissue condition and any implanted material? provenance
2. What follow-up evidence distinguishes intact repair, residual defect and recurrence, and what remains unassessed? measurement

Check these first

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these check these first hold for the sense of diaphragmatic rupture this model covers, and on what evidence? provenance

Kinds and varieties

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these kinds and varieties hold for the sense of diaphragmatic rupture this model covers, and on what evidence? provenance

Real-world use

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these real-world use hold for the sense of diaphragmatic rupture this model covers, and on what evidence? provenance

Failure modes and hazards

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these failure modes and hazards hold for the sense of diaphragmatic rupture this model covers, and on what evidence? provenance

Neighbouring kinds and how to tell them apart

Recalled without web access and unsourced; every item is a lead to verify.

1. Which of these neighbouring kinds and how to tell them apart hold for the sense of diaphragmatic rupture this model covers, and on what evidence? provenance