Which statement correctly explains why post-traumatic diaphragmatic hernia more often involves the left hemidiaphragm?
- A The liver buttresses and absorbs force applied to the right hemidiaphragm ✓
- B The left hemidiaphragm is congenitally thinner than the right
- C Left sided injuries produce symptoms earlier and are therefore diagnosed more often
- D Blunt trauma produces radial tears that occur preferentially on the left
Correct answer: A. The liver buttresses and absorbs force applied to the right hemidiaphragm
Explanation
The liver lies immediately beneath the right hemidiaphragm and dissipates transmitted pressure, protecting it, while the left side contains only stomach, spleen and bowel and tears more readily. Diagnosis is also missed more often on the right precisely because the liver plugs the defect, which makes option C wrong. Tears usually follow the peripheral attachment rather than being inherently left sided radial patterns.
Reference: Sabiston Textbook of Surgery, 21st ed.
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