Trauma: diaphragmatic rupture: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Trauma: diaphragmatic rupture

Sample item

After a high-speed crash a patient has respiratory distress, and the chest film shows a nasogastric tube coiled in the left hemithorax with loss of the left hemidiaphragm outline. Which statement is correct?

AConservative management is adequateBRepair is deferred for monthsCLeft-sided rupture is more common because the liver protects the right sideDRight-sided rupture is more common

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Left-sided rupture is more common because the liver protects the right side

Blunt trauma tears the diaphragm, usually the left posterolateral part, and the liver protects the right side. Abdominal contents herniate into the chest, and a gastric tube in the thorax is a classic sign. Repair is undertaken promptly through the abdomen in acute injuries, as herniation can strangulate.

Option by option

A. Conservative management is adequate
Spontaneous healing does not occur.
B. Repair is deferred for months
Delayed repair risks strangulation of herniated viscera.
C. Left-sided rupture is more common because the liver protects the right side (correct)
Correct. The liver shields the right hemidiaphragm.
D. Right-sided rupture is more common
Right-sided injuries are less common.

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.

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Left-sided rupture is more common because the liver protects the right side. Blunt trauma tears the diaphragm, usually the left posterolateral part, and the liver protects the right side.

Why is "Conservative management is adequate" not the answer?

Spontaneous healing does not occur.

Why is "Repair is deferred for months" not the answer?

Delayed repair risks strangulation of herniated viscera.

Why is "Right-sided rupture is more common" not the answer?

Right-sided injuries are less common.

What concept does this question test?

It tests Trauma: diaphragmatic rupture in General Surgery. Abdominal contents herniate into the chest, and a gastric tube in the thorax is a classic sign. Repair is undertaken promptly through the abdomen in acute injuries, as herniation can strangulate.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma: diaphragmatic rupture?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.