Evaluation of intrapleural contrast-enhanced abdominal pelvic CT-scan in detecting diaphragm injury in stable patients with thoraco-abdominal stab wound: A preliminary study

Abbasy, Hamid Reza; Panahi, F; Sefidbakht, Sepideh; Akrami, Majid; Paydar, Shahram; Mirhashemi, Sedighe; Bolandparvaz, Shahram; Asaadi, Kambiz; Salahi, Roohollah

doi:10.1016/j.injury.2011.06.017

Cited by 7 publications

(2 citation statements)

References 24 publications

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“…[12] Repeated imaging including CT was negative for diaphragmatic injury in a ventilated head injured patient, which could be diagnosed only on postmortem similar to report by Pantelis et al . [13] Intrapleural-contrast CT scan[14] and M - mode ultra sonography (USG)[15] have been promising. HYPERLINK “/article/S0020-1383 (10) 00773-4/abstra.…”

Section: Discussionmentioning

confidence: 99%

Injury to the diaphragm: Our experience in Union Head quarters Hospital

Radjou

Balliga

Uthrapathy

et al. 2013

Int J Crit Illn Inj Sci

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Background:Diaphragmatic injury is a global diagnostic and therapeutic challenge.Objectives:The study was to identify the variations in the risk factors, diagnosis, management, and outcome between blunt and penetrating injuries of the diaphragm.Materials and Methods:A prospective study was conducted on patients who were diagnosed with injury to diaphragm during preoperative, intraoperative, or postmortem period. The risk correlates and the trail of events following injury, interventions, and outcomes were studied.Results:Of the 25 cases, blunt injury was experienced by 10. Road traffic injury was the most common cause in blunt trauma and assault with knife in penetrating trauma. Acute presentation was the most common mechanism. X-rays were positive in 52% cases. The most common reason for false negative X-rays was massive effusion/hemothorax. Computed tomography (CT) improved the positivity rate to 62.5%. A total of 25% of diaphragmatic injuries were diagnosed during surgery for hemodynamic instability irrespective of initial X-rays findings. Laprotomy alone was sufficient in majority of cases. The defects were largely in the left side; mean defect size was more in blunt trauma. Associated injuries were noted in 92%. Stomach was most affected in penetrating injuries and spleen in blunt trauma. Empeyma was the most common morbidity. Mortality rate of 13% in penetrating injury was far lower than 60% in blunt injury. Mean Injury Severity Score (ISS) was significantly related to the fatal outcomes irrespective of mechanism. Diagnostic laparoscopy for asymptomatic low velocity junctional penetrating wounds revealed diaphragmatic injury in 20%.Conclusions:The incidence of multisystem injuries at our trauma center is on the rise. A high index of suspicion is needed for diagnosis of diaphragmatic injury. The need for thorough exploratory laprotomy is essential. In resource stretched setting like ours, the need for routine diagnostic laparoscopy in asymptomatic junctional wounds has to be validated further.

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Section: Discussionmentioning

confidence: 99%

Injury to the diaphragm: Our experience in Union Head quarters Hospital

Radjou

Balliga

Uthrapathy

et al. 2013

Int J Crit Illn Inj Sci

View full text Add to dashboard Cite

show abstract

“…While it is relatively simple to evaluate diaphragms in patients in need of laparotomy, it is difficult in the remaining asymptomatic patient population. Diagnostic laparotomy is regarded as the gold standard for detection and treatment of diaphragmatic injuries, although computed tomography may also become diagnostic in some patients [1,2,5,11,12,[16][17][18][19][20][21][22]. The aim of this study was to determine the role of computed tomography in detection of diaphragmatic injury in patients with PLTSI.…”

Section: Introductionmentioning

confidence: 99%