Diaphragmatic injuries after blunt trauma: are they still a challenge?

Bocchini, Giorgio; Guida, Franco; Sica, Giacomo; Codella, Umberto; Scaglione, Mariano

doi:10.1007/s10140-012-1025-4

Cited by 43 publications

(26 citation statements)

References 38 publications

(155 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1][2][3] The most common location of a diaphragmatic rupture is the left side (56%-86%), followed by the right side (11%-39%); a small percentage of cases are bilateral (2%-6%). 4,7) Most of the ruptures occur at the posterolateral aspect, which is the weakest point of the diaphragm. 1) They are classified into two broad categories according to the time of diagnosis: acute phase and late phase.…”

Section: * Liver Diaphragmatic Rupture Resulting In a Hemothoraxmentioning

confidence: 99%

“…Blunt diaphragmatic ruptures in the acute phase are frequently associated with life-threatening injuries to the thoracoabdominal organs. [1][2][3][4][5] For example, liver injuries are seen in 93% of patients with right-sided rupture. 7) In contrast, the most common complication during the late phase is herniation of intra-abdominal organs into the thoracic cavity.…”

Section: * Liver Diaphragmatic Rupture Resulting In a Hemothoraxmentioning

confidence: 99%

“…CT is the gold standard diagnostic modality and allows the visualization of other associated intra-abdominal injuries, if present. [1][2][3][4][5] However, in patients with right-sided diaphragmatic ruptures, diagnosis using CT images is often difficult because the diaphragmatic laceration may be obscured by the liver. 2,10) Video-assisted thoracoscopic surgery (VATS) is a more accurate method for diagnosis in these cases.…”

Section: * Liver Diaphragmatic Rupture Resulting In a Hemothoraxmentioning

confidence: 99%

“…[1][2][3][4][5] They mostly occur in the left-sided hemidiaphragm with herniation or associated thoracoabdominal organ injuries after a motor vehicle accident. [1][2][3][4][5] We report an unusual case of diaphragmatic rupture after a slip-and-fall accident resulting in a delayed life-threatening hemothorax, which was successfully treated through a video-assisted minithoracotomy.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Video-Assisted Minithoracotomy for Blunt Diaphragmatic Rupture Presenting As a Delayed Hemothorax

Ota

Kawai

Matsuo

2014

ATCS

View full text Add to dashboard Cite

Diaphragmatic ruptures after blunt trauma are rare life-threatening conditions. Most of them occur on the left-sided hemidiaphragm with herniation or associated organ injuries after a motor vehicle accident. We present an unusual case of blunt diaphragmatic rupture resulting in a delayed hemothorax. A 62-year-old man presented with acute dyspnea that initiated while straining to pass stool. He had a bruise on the lower back region of his right thorax after a slip-and-fall accident 7 days previously. Chest computed tomographic scans revealed a right-sided hemothorax without any evidence of herniation or associated organ injuries. Emergency surgery was performed through a video-assisted minithoracotomy. During surgery, we identified a diaphragmatic laceration with a severed blood vessel originating from the right superior phrenic artery. The lesion was repaired with interrupted horizontal mattress sutures. The total amount of bleeding was approximately 2000 mL. The patient had an uneventful recovery with no further bleeding episodes.

show abstract

Section: * Liver Diaphragmatic Rupture Resulting In a Hemothoraxmentioning

confidence: 99%

Section: * Liver Diaphragmatic Rupture Resulting In a Hemothoraxmentioning

confidence: 99%

Section: * Liver Diaphragmatic Rupture Resulting In a Hemothoraxmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Video-Assisted Minithoracotomy for Blunt Diaphragmatic Rupture Presenting As a Delayed Hemothorax

Ota

Kawai

Matsuo

2014

ATCS

View full text Add to dashboard Cite

show abstract

“…Most of the studies about the individual CT signs of diaphragmatic injury have focused only on blunt trauma (2)(3)(4)(5)(6)(11)(12)(13). Moreover, to our knowledge, no analysis of the dangling diaphragm sign has been conducted in both blunt and penetrating trauma patients (5).…”

Section: Resultsmentioning

confidence: 99%

Traumatic diaphragmatic injury: a review of CT signs and the difference between blunt and penetrating injury

Panda¹,

Kumar²,

Gamanagatti³

et al. 2014

Diagn Interv Radiol

View full text Add to dashboard Cite

ORIGINAL ARTICLE PURPOSE We aimed to present the frequency of computed tomography (CT) signs of diaphragmatic rupture and the differences between blunt and penetrating trauma. MATERIALS AND METHODSThe CT scans of 23 patients with surgically proven diaphragmatic tears (both blunt and penetrating) were retrospectively reviewed for previously described CT signs of diaphragmatic injuries. The overall frequency of CT signs was reported; frequency of signs in right-and left-sided injuries and blunt and penetrating trauma were separately tabulated and statistically compared. RESULTSThe discontinuous diaphragm sign was the most common sign, observed in 95.7% of patients, followed by diaphragmatic thickening (69.6%). While the dependent viscera sign and collar sign were exclusively observed in blunt-trauma patients, organ herniation (P = 0.05) and dangling diaphragm (P = 0.0086) signs were observed significantly more often in blunt trauma than in penetrating trauma. Contiguous injury on either side of the diaphragm was observed more often in penetrating trauma (83.3%) than in blunt trauma (17.7%). CONCLUSIONKnowledge of the mechanism of injury and familiarity with all CT signs of diaphragmatic injury are necessary to avoid a missed diagnosis because there is variability in the overall occurrence of these signs, with significant differences between blunt and penetrating trauma.

show abstract