Current RMA Instruments
| Reasonable Hypothesis SOP | 99 of 2022 |
| Balance of Probabilities SOP | 100 of 2022 |
SOP bulletin information on new Instruments
ICD Coding
ICD-10-AM Code: K44.2
Brief description
This is a herniation of abdominal contents into the chest cavity through the diaphragm (not including through the diaphragmatic opening - which is covered by the SOP for hiatus hernia). This is a rare condition which mostly results from significant trauma.
Confirming the diagnosis
This diagnosis is made from radiological imaging of the chest/abdomen, or at the time of surgery (e.g. laparoscopy, thoracoscopy).
The appropriate medical specialist is thoracic, general or trauma surgeon or a gastroenterologist.
Additional diagnoses covered by SOP
- Nil
Conditions excluded from SOP
- Congenital diaphragmatic hernia#
- Eventration of the diaphragm# (abnormal placement of the diaphragm - too high in the chest cavity, due to nerve/muscle problems)
- Hiatus hernia*
* Another SOP applies
# Non-SOP condition
Clinical onset
Most diaphragmatic hernias will occur acutely and be found on evaluation of someone with significant, acute, penetrating or blunt trauma. Delayed diagnosis and chronic presentations can occur with smaller hernias or those from other rare causes. Symptoms may include dyspepsia, shortness of breath or chest pain.
Clinical worsening
Worsening is unlikely as surgical repair will be routinely undertaken without delay once a diagnosis is made.