Magnetic resonance imaging of blunt traumatic rupture of the right hemidiaphragm

Dosios, T.; Papachristos, Ioannis V.; Chrysicopoulos, H

doi:10.1016/1010-7940(93)90056-h

Cited by 16 publications

(7 citation statements)

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“…CT has greatly enhanced the ability of early diagnosis and is reported to have a sensitivity of 71% (78% for the left and 50%for the right) and a speci city of 100% and an accuracy of 88% for the left and 70% for the right sided injuries. 24 With CT scan, the early diagnosis rates were signi cantly higher than it had been before (p = .042) ( Table II).…”

Section: Resultsmentioning

confidence: 86%

Surgical Management of Traumatic Diaphragmatic Hernia: a Single Institutional Experience of More Than Two Decades.

Deng

Huang

2020

Preprint

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Background: We present here our experience with surgical management of traumatic diaphragmatic hernia, trying to find out the era impact of different periods on the outcome and risk factors of mortality. Methods: A series of 63 patients with traumatic diaphragmatic hernia were referred to us and operated on during March, 1990-August, 2017. The patient records were reviewed and statistically analyzed to demonstrate injury characteristics and to find out optimal treatment strategy, risk factors of death as well as the difference between two periods (1990-2005, 2005-2017) divided by introduction of computed tomography at our institution.Results: The overall mean age was 31.2±16.3 years old with a female to male ratio of 11/52. The mechanism was penetrating trauma in 19 cases (30.2%), and blunt trauma in 44 cases (69.9%). Two thirds of the patients in the latter period yet none in the former period underwent computed tomography. Ten patients (15.9%), of which 8 in the former and the other 2 in the latter period (p=.042), had late diagnoses. The most commonly used incision was a thoracotomy (n=43, 89.6%). There was no statistical difference in etiology or mortality between the two periods. Univariate analysis showed survivors were younger, and had lesser injury severity scores (ISS) and lower American Association for the Surgery of Trauma (AAST) grade than nonsurvivors. By multiple logistic regression analysis, increased age (odds ratio, 1.275; p=.013) and greater ISS (OR, 1.174; p=.028) were risk factors of death in all patients.Conclusions: High definition computed tomography has significantly improved the preoperative diagnosis rate. The transthoracic approach could be used in selected cases with traumatic diaphragmatic hernia with good outcomes. Patients with greater ISS and advanced age are at higher risk of death.

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Section: Resultsmentioning

confidence: 86%

Surgical Management of Traumatic Diaphragmatic Hernia: a Single Institutional Experience of More Than Two Decades.

Deng

Huang

2020

Preprint

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“…However, magnetic resonance imaging (MRI) affords the clearest visualization of the diaphragm itself and is better than a CT scan for showing a right torn diaphragm and differentiating between pleural effusion and hepatic migration into the chest. 12 Gastric volvulus is also a rare event, first described by Paré in 1579. 13 It is an acquired abnormal rotation of the stomach, which may be intra-abdominal or intrathoracic.…”

Section: Discussionmentioning

confidence: 99%

Acute Intrathoracic Gastric Volvulus from a Diaphragmatic Hernia after Left Splenopancreatectomy: Report of a Case

et al. 2006

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Intrathoracic gastric volvulus is a rare event. It occurs when the stomach undergoes organoaxial torsion in the chest, caused either by concomitant enlargement of the hiatus or by a diaphragmatic hernia. A delay in diagnosis and treatment can result in fatal complications such as gastric ischemia, perforation, and hemorrhage. We report a case of intrathoracic localization of an acute and incarcerated organoaxial gastric volvulus caused by a left-sided diaphragmatic hernia resulting from a diaphragmatic injury. The patient had undergone a left splenopancreatectomy 4 years earlier for non-Hodgkin's lymphoma. We performed an emergency left thoracotomy with reduction of the acute volvulus, resection of the adhesions, and exeresis of an inflammatory mass from the omentum, with good results. The mechanisms of volvulus and diaphragmatic hernia with the relative diagnostic and therapeutic implications are discussed after this case report.

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“…15 Right-sided diaphragmatic rupture has been successfully diagnosed by magnetic resonance imaging (MRI), ultrasound, and technetium scanning. [16][17][18] The best surgical approach is ultimately determined by the presence of any associated injuries. In the absence of a definitive diagnosis of diaphragmatic injury, the decision about the best approach to take is difficult.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2005

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Blunt diaphragmatic injury is an increasingly common occurrence, frequently associated with considerable comorbidity. This injury is often missed at the time of the initial event, but may present some time later. We report three cases of diaphragmatic injury diagnosed 3 weeks, 6 months, and 12 years after the original diaphragmatic injury, respectively. Two of the injuries resulted from side-impact road traffic accidents and one followed a fall from a height. Gastrointestinal obstruction and respiratory compromise were the major presenting symptoms. All three patients were managed with a thoracotomy and the defect was closed without the need for prosthetic mesh. They all recovered uneventfully and have remained well since.

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Magnetic resonance imaging of blunt traumatic rupture of the right hemidiaphragm

Abstract: A patient suffering from blunt traumatic rupture of the right hemidiaphragm is presented. Chest radiography and computed tomography (CT) suggested the type of injury, but magnetic resonance imaging (MRI) established unequivocally the correct preoperative diagnosis.

Cited by 16 publications

References 0 publications

Surgical Management of Traumatic Diaphragmatic Hernia: a Single Institutional Experience of More Than Two Decades.

Surgical Management of Traumatic Diaphragmatic Hernia: a Single Institutional Experience of More Than Two Decades.

Acute Intrathoracic Gastric Volvulus from a Diaphragmatic Hernia after Left Splenopancreatectomy: Report of a Case

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

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