Background : The diagnostic rate of blunt diaphragmatic injuries (BDIs) has improved with the use of multi-detector computed tomography (MDCT). However, we believe that cases for which a diagnosis is difficult still exist. We evaluated the limitations in diagnosing BDIs using MDCT based on diaphragmatic injury (DI) size. Methods : We retrospectively examined 15 patients with BDIs who underwent preoperative MDCT before operative treatment between January 2006 and December 2015. Clinical features, preoperative diagnostic rate, and diaphragmatic injury findings were evaluated. Results : Study subjects comprised ten men and five women (mean age, 48 years). Road traffic accidents were the main cause of injury. The average DI size was 13.1 ± 9.1 (range 1-33) cm. A diagnosis of BDI was missed in two patients with very small DIs without hernia (preoperative diagnostic rate, 86.7%). Conclusions : Diagnosing MDCT is still challenging for patients with small sized DI without hernia.
