Treatment

Consider the following:

• Insert a nasogastric tube gently to drain stomach content. The insertion of the chest drain is to drain any associated pneumo/haemothoraces.
• A cautiously placed chest drain using the traditional open technique, not Seldinger, is indicated
• Surgical repair needs to be considered in the context of associated injuries
• Examine the CT carefully in patients who have sustained a (blunt) abrupt increase in intra-abdominal pressure
• Diaphragmatic injury needs excluding by your surgical colleagues in cases of penetrating injury requiring theatre.