Imaging hemidiaphragmatic injury

Shanmuganagthan, Kathirkamanathan

doi:10.1007/s00330-006-0553-2

Cited by 63 publications

(67 citation statements)

References 41 publications

(73 reference statements)

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“…[1,2,4,8] In our study, a diagnosis of diaphragmatic rupture was made via this method in just 10 of the patients (33%). In hemodynamically stable subjects who cannot be diagnosed with conventional pulmonary X-rays, CT may be used.…”

Section: Discussionmentioning

confidence: 89%

“…Coronal and sagittal magnetic resonance imaging (MRI) ensures that the whole diaphragm is optimally imaged and that organs which are herniating into the thoracic cavity can be clearly viewed. [8] However, MRI is not often used since it is more time consuming than other imaging methods. For this reason, we did not use MRI in any of our cases.…”

Section: Discussionmentioning

confidence: 99%

“…[2,7,8] The rate of organ damage associated with diaphragmatic trauma was reported as 86.9% by Hanna et al, [7] 95% by Mihos et al, [4] and 88% by Düzgün et al [6] In addition, those authors reported that 92% of the patients who died had associated pathologies. In our study, the rate of organ injury associated with TDR was 83%, but this rate was 100% in the seven deceased patients.…”

Section: Discussionmentioning

confidence: 99%

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Factors affecting mortality in traumatic diaphragmatic ruptures

Tarladacalisir¹

2014

Turk Gogus Kalp Dama

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Amaç: Bu çalışmada diyafram rüptürü nedeni ile cerrahi uygulanan hastalarda mortaliteyi ekileyen olası faktörler araştırıldı. Ça lış mapla nı:Mayıs 1997 -Mayıs 2009 tarihleri arasında toplam 30 hasta (27 erkek, 3 kadın; ort. yaş 42.6 yıl; dağı-lım 16-88 yıl) diyafram rüptürü nedeni ile kliniğimizde ameliyat edildi. Hastalar mortaliteyi etkileyen olası faktör-ler açısından retrospektif olarak değerlendirildi. Yirmi iki hastaya acil cerrahi girişim ilk yedi günde uygulandı. Diğer altı hasta latent fazda ve iki hasta obstrüktif fazda ameliyat edildi. Bul gu lar: Dokuz hastaya torakotomi, dokuz hastaya laparotomi ve 12 hastaya torakotomi ve laparotomi yapıldı. Sekiz hastaya eksploratif laparotomi ile tanı konuldu. Hastanede kalış süresi ortalama 12 gün (1-50 gün) idi. Sekiz hastada morbidite (%27) görülür iken, yedi hastada (%23) mortalite görüldü. Beş hastada eşlik eden yaralanma bulunamaz iken, 25 hastada eşlik eden yaralanmalar vardı. Bu hastaların 16'sında (%53) eşlik eden yaralanmalar için ek cerrahi girişimler gerekti. İleri yaş (p= 0.020) ve daha uzun süre yoğun bakım ihtiyacı olması (p= 0.020) mortaliteyi negatif yönde etkileyen faktörler olarak bulundu. So nuç:Eşlik eden organ yaralanmaları morbidite ve mortaliteyi etkileyen ana prognostik faktördür. İleri yaş ve travmatik diyafram rüptürüne eşlik eden organ yaralanması olan hastaların mekanik ventilatörden erken ayrılması, agresif tedavi ve yakın takibi, morbidite ve mortaliteyi azaltabilir.Anah tar söz cük ler: Diyafram; mortalite; rüptür; travma.Background:This study aims to investigate possible factors affecting mortality in patients with traumatic diaphragmatic ruptures. Methods: Between May 1997 and May 2009 a total of 30 patients (27 males, 3 females; mean age 42.6 years; range 16 to 88 years) were operated in our clinic with a diagnosis of traumatic diaphragmatic rupture. The patients were evaluated retrospectively in terms of possible factors affecting mortality. Emergency surgery was performed 22 patients within the first seven days. Other two patients were operated in the latent phase and six patients were operated in the obstructive phase. Results: Thoracotomy was performed in nine patients, laparotomy in nine patients and thoracotomy + laparotomy in 12 patients. Eight patients were diagnosed by explorative laparotomy. The mean duration of hospitalization was 12 days (range, 1-50 days). Morbidity was observed in eight patients (27%), while mortality was seen in seven patients (23%). Five patients had no associated pathology, while various associated pathologies were observed in 25 patients. Additional surgical interventions were required for associated pathologies in 16 of these patients (53%). Older age (p=0.020) and need for longer length of stay in the intensive care unit (p=0.020) were found to be negative prognostic factors affecting mortality. Conclusion: Associated organ injuries are the main prognostic factors which affect morbidity and mortality. Early weaning from mechanical ventilation, aggressive treatment and close follow-up of pati...

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Factors affecting mortality in traumatic diaphragmatic ruptures

Tarladacalisir¹

2014

Turk Gogus Kalp Dama

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“…On CT absence of continuity of diaphragm are the most sensitive sign & "Collar sign" being specific. 13 The evaluation of the diaphragm by laparotomy remains the gold standard for diagnosis. 12,13 Anesthetic management is very challenging in such cases & needs expertise & preparedness.…”

Section: Discussionmentioning

confidence: 99%

Delayed Presentation of Tension Gastrotho Rax Complicating Acute Traumatic Diap Hragmatic Rupture

Sahajananda¹,

T²,

Karthik³

et al. 2015

jemds

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“…Coronal and sagittal reformatted images are recommended, especially for diaphragmatic tear recognition. 15 Diaphragmatic rupture can be diagnosed with CT by the presence of: direct visualization of injury, segmental diaphragm non-visualization, intrathoracic herniation of viscera, peridiaphragmatic active contrast extravasation, the collar sign (a waist-like diaphragmatic constriction of herniated organs), and the positive dependent viscera sign (the herniated viscera [bowel or solid organs] are no longer supported posteriorly by the injured diaphragm and fall to a dependent position against the posterior ribs upon CT examination). 14,16 The CT collar sign has a reported low sensitivity (67% for left-sided ruptures and 50% for right-sided injuries) but a specificity of 100%.…”

Section: Discussionmentioning

confidence: 99%