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General Surgery · Trauma surgery: diaphragmatic rupture
Sample itemAfter high-energy left thoracoabdominal trauma, a chest radiograph shows bowel loops in the left hemithorax. What injury is most likely?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Left diaphragmatic rupture
Traumatic diaphragmatic rupture is more commonly recognized on the left because the liver protects the right side. Herniation of abdominal viscera into the chest can compromise ventilation and requires surgical repair.
Option by option
A. Simple pneumothorax
Pneumothorax contains pleural air, not bowel loops.
B. Left diaphragmatic rupture (correct)
Correct. Intrathoracic bowel after trauma strongly suggests diaphragmatic rupture.
C. Isolated clavicle fracture
Clavicle fracture cannot produce intrathoracic bowel.
D. Pulmonary contusion only
Contusion causes parenchymal opacities, not herniated viscera.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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