True about diaphragmatic injury

Contrast studies of the upper or lower gastrointestinal tract, CT scan and diagnostic peritoneal lavage all lack positive or negative predictive value. The most accurate evaluation is by video-assisted thoracoscopy (VATS) or laparoscopy, the latter offering the advantage of allowing the surgeon to proceed to a repair and additional evaluation of the abdominal organs Operative repair is recommended in all cases. All penetrating diaphragmatic injury must be repaired the abdomen and not the chest, to rule out penetrating hollow viscus injury. Ref : Bailey and love 26thE pg826