Blunt diaphragmatic rupture - a rare but challenging entity in thoracoabdominal trauma

Kuo, I-Ming; Liao, Chien‐Hung; Hsin, Ming-Che; Kang, Shih‐Ching; Wang, Shang‐Yu; Ooyang, Chun-Hsiang; Fang, Ji‐Tseng

doi:10.1016/j.ajem.2011.03.014

Cited by 24 publications

(28 citation statements)

References 22 publications

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“…In a recent study, haemopneumothorax was the most commonly associated injury (37.2%) seen in patients with a delayed diagnosis of diaphragmatic rupture with an average diagnostic time of 8 h. It was also noted through several reports that the missed diagnosis was found to be between 12% and 66% 4. Chest x-ray remains a common screening tool, however, CT has become the gold standard for diagnosing diaphragmatic injuries with an overall sensitivity of 90%, with 100% and 75% specificity for left-sided and right-sided rupture, respectively 5…”

Section: Key Questionsmentioning

confidence: 94%

Short answer question case series: unique chest x-ray following blunt trauma

Slater¹,

Dalawari²,

Jang

2013

Emerg Med J

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Section: Key Questionsmentioning

confidence: 94%

Short answer question case series: unique chest x-ray following blunt trauma

Slater¹,

Dalawari²,

Jang

2013

Emerg Med J

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“…It is often associated with severe blunt trauma1 with the most common precipitant being car collisions 2…”

Section: Introductionmentioning

confidence: 99%

Delayed presentation of post-traumatic diaphragm rupture repaired by laparoscopy

2012

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Diaphragmatic rupture is a serious but frequently missed condition that is potentially curable. While surgical management has classically been performed through open thoracotomy, a laparoscopic approach has been suggested as a preferable alternative. A man in his mid-50s presented with non-specific abdominal symptoms, 8 months after falling down some stairs. Diaphragmatic rupture was suspected after old rib fractures were noticed on an admitting chest radiograph. Further signs and symptoms presented following deterioration due to the unstable pathology. Prompt surgical treatment using laparoscopy was attempted with success and resulted in rapid and lasting improvement in symptoms.

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“…However, the true incidence is unknown due to the presence of undiagnosed lesions [1][2][3] . In blunt trauma, there is a sudden increase in abdominal pressure that may lead to rupture of the muscular or membranous portion of the diaphragm, especially when the trauma is associated with great impact energy [2][3][4][5] . Most of these lesions occur in the posterolateral aspect of the left side, an area of weakness originating from the pleuroperitoneal membrane.…”

Section: Introductionmentioning

confidence: 99%

“…In trauma acute phase, the clinical examination hardly contributes to the diagnosis, and the injury can easily go unnoticed in the primary evaluation, at a frequency ranging from 7% to 66% 2,5,6,10 . Original Article A B S T R A C T the adipose tissue, being more difficult on the right side, since the liver is iso-attenuating with the diaphragm 8 .…”

Section: Introductionmentioning

confidence: 99%

“…Original Article A B S T R A C T the adipose tissue, being more difficult on the right side, since the liver is iso-attenuating with the diaphragm 8 . The current tendency regarding the nonoperative treatment of intra-abdominal organs blunt lesions can result in a greater diagnosis delay, the diagnosis by imagingbeing essential to guarantee adequate surgical repair 2,6 .…”

Section: Introductionmentioning

confidence: 99%

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Análise retrospectiva de 103 casos de lesão diafragmática operados em um centro de trauma

Cardoso

Gonçalves

Machado

et al. 2017

Rev. Col. Bras. Cir.

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RESUMO Objetivo: analisar os fatores associados ao óbito em pacientes com lesão diafragmática atendidos em hospital de referência para o trauma. Métodos: estudo retrospectivo de pacientes com lesão do diafragma atendidos no Hospital Risoleta Tolentino Neves da Universidade Federal de Minas Gerais entre janeiro de 2010 e dezembro de 2014. Foi utilizado o Banco de Registros de Trauma Collector® (MD, USA). Utilizaram-se dados demográficos, localização da lesão diafragmática, lesões associadas de outros órgãos, número de lesões associadas, tipo de abordagem terapêutica, complicações e o escore de gravidade Injury Severity Score (ISS). A variável de interesse foi a ocorrência de óbito. Resultados: foram identificados 103 pacientes e a incidência de óbito foi de 16,5%. Lesões penetrantes ocorreram em 98% dos pacientes. Em análise univariada a mortalidade foi maior em pacientes cujo tratamento foi não operatório, sem rafia (p=0,023), e menor em pacientes submetidos à rafia diafragmática (p<0,001). O aumento do número de lesões associou-se ao aumento da incidência de óbitos (p=0,048). Em análise multivariada, ISS>24 (OR=4,0; p=0,029) e rafia do diafragma (OR=0,76; p<0,001) associaram-se à mortalidade. Conclusão: os achados indicam que a ruptura traumática do diafragma raramente se apresenta como lesão isolada, estando associada frequentemente à lesão de outros órgãos, especialmente fígado e vísceras ocas. Pode-se afirmar que a mortalidade foi mais elevada entre aqueles com ISS>24.

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Blunt diaphragmatic rupture - a rare but challenging entity in thoracoabdominal trauma

Cited by 24 publications

References 22 publications

Short answer question case series: unique chest x-ray following blunt trauma

Short answer question case series: unique chest x-ray following blunt trauma

Delayed presentation of post-traumatic diaphragm rupture repaired by laparoscopy

Análise retrospectiva de 103 casos de lesão diafragmática operados em um centro de trauma

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