Multitrauma with diaphragmatic rupture and pelvic fractures

Discussion:

In the trauma setting, pneumomediastinum can be due to blunt chest trauma or, less commonly, from injury to the tracheobronchial tree or esophagus. CT is useful for evaluating for a suspected tracheobronchial or esophageal tear but even if present, the injury may not be visible. 

The pelvis functions as a ring and hence when a disruption is identified, there must be a high suspicion for disruption at another location. Hence if you find one fracture, look hard for another. Pelvic fractures increase the risk of mortality primarily because of hemorrhage so always look for active bleeding.

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