Delayed Discovery of Diaphragmatic Injury After Blunt Trauma: Report of Three Cases

Healy, David; Veerasingam, Davendran; Luke, David; Wood, A. E.

doi:10.1007/s00595-004-2947-6

Cited by 12 publications

(6 citation statements)

References 19 publications

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“…Because the right diaphragm is protected by the liver, such injuries almost exclusively involve the left diaphragm [4-6]. Diaphragmatic ruptures may be revealed many years after the initial trauma, presenting as abdominal visceral herniation and complications such as strangulation and perforation [7]. …”

Section: Discussionmentioning

confidence: 99%

Diaphragmatic rupture with right colon and small intestine herniation after blunt trauma: a case report

et al. 2010

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IntroductionTraumatic diaphragmatic hernias are an unusual presentation of trauma, and are observed in about 10% of diaphragmatic injuries. The diagnosis is often missed because of non-specific clinical signs, and the absence of additional intra-abdominal and thoracic injuries.Case presentationWe report a case of a 59-year-old Italian man hospitalized for abdominal pain and vomiting. His medical history included a blunt trauma seven years previously. A chest X-ray showed right diaphragm elevation, and computed tomography revealed that the greater omentum, a portion of the colon and the small intestine had been transposed in the hemithorax through a diaphragm rupture. The patient underwent laparotomy, at which time the colon and small intestine were reduced back into the abdomen and the diaphragm was repaired.ConclusionsThis was a unusual case of traumatic right-sided diaphragmatic hernia. Diaphragmatic ruptures may be revealed many years after the initial trauma. The suspicion of diaphragmatic rupture in a patient with multiple traumas contributes to early diagnosis. Surgical repair remains the only curative treatment for diaphragmatic hernias. Prosthetic patches may be a good solution when the diaphragmatic defect is severe and too large for primary closure, whereas primary repair remains the gold standard for the closure of small to moderate sized diaphragmatic defects.

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Section: Discussionmentioning

confidence: 99%

Diaphragmatic rupture with right colon and small intestine herniation after blunt trauma: a case report

et al. 2010

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“…25 In the acute trauma setting, the associated injuries may preoccupy the surgeon, who will often miss coexisting diaphragmatic injuries. 27 Currently, the management of blunt trauma in the absence of hemodynamic instability has been trending toward a nonoperative approach. As a result of its subtle and potentially asymptomatic clinical presentation, the absence of obvious external deformities, and a lack of unequivocal and timely diagnostic methods at the time of initial trauma, delayed diagnosis of TDH have been reported in 30 per cent to 50 per cent of patients.…”

Section: Historical Overviewmentioning

confidence: 99%

Posttraumatic Hernias: Historical Overview and Review of the Literature

Crandall

Popowich

Shapiro

et al. 2007

The American Surgeon

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Diaphragmatic, lumbar, and extra-thoracic hernias are well-described complications of blunt trauma. However, in the absence of an immediate indication for surgery in the injured patient, early recognition of these hernias can be a diagnostic challenge and delayed presentation is common. Upon diagnosis, surgical repair is necessary secondary to the high morbidity and mortality associated with herniation and strangulation of abdominal organs. Surgical treatment of these hernias is evolving and a variety of options are available to the surgeon. This article will provide a historical overview of post-traumatic diaphragmatic and multi-cavity hernias, and a review of the literature addressing key issues of diagnosis and management.

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“…As a result of several widely publicized fatalities and malpractice claims and the lack of uniform regulation of office-based practices, research efforts have begun to address some of the controversial issues and turn attention to patient safety in the office 3 4 5 6 7 8 . In 2003, Vila et al 9 compared 2 years of reported adverse events and concluded that the relative risk of complications and death was 10 times greater in the office-based practices compared to ASCs.…”

Section: Introductionmentioning

confidence: 99%

Safe anesthesia for office-based plastic surgery: Proceedings from the PRS Korea 2018 meeting in Seoul, Korea

Osman

Shapiro

2019

Arch Plast Surg

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There has been an exponential increase in plastic surgery cases over the last 20 years, surging from 2.8 million to 17.5 million cases per year. Seventy-two percent of these cases are being performed in the office-based or ambulatory setting. There are certain advantages to performing aesthetic procedures in the office, but several widely publicized fatalities and malpractice claims has put the spotlight on patient safety and the lack of uniform regulation of office-based practices. While 33 states currently have legislation for office-based surgery and anesthesia, 17 states have no mandate to report patient deaths or adverse outcomes. The literature on office-base surgery and anesthesia has demonstrated significant improvements in patient safety over the last 20 years. In the following review of the proceedings from the PRS Korea 2018 meeting, we discuss several key concepts regarding safe anesthesia for officebased cosmetic surgery. These include the safe delivery of oxygen, appropriate local anesthetic usage and the avoidance of local anesthetic toxicity, the implementation of Enhanced Recovery after Surgery protocols, multimodal analgesic techniques with less reliance on narcotic pain medications, the use of surgical safety checklists, and incorporating “the patient” into the surgical decision-making process through decision aids.

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Delayed Discovery of Diaphragmatic Injury After Blunt Trauma: Report of Three Cases

Cited by 12 publications

References 19 publications

Diaphragmatic rupture with right colon and small intestine herniation after blunt trauma: a case report

Diaphragmatic rupture with right colon and small intestine herniation after blunt trauma: a case report

Posttraumatic Hernias: Historical Overview and Review of the Literature

Safe anesthesia for office-based plastic surgery: Proceedings from the PRS Korea 2018 meeting in Seoul, Korea

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