Penetrating Trauma to the Diaphragm

Zierold, Dustin; Perlstein, Jon; Weidman, Eric R.; Wiedeman, James E.

doi:10.1001/archsurg.136.1.32

Cited by 29 publications

(4 citation statements)

References 21 publications

(26 reference statements)

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“…The rupture typically originates at the central tendineum or musculotendinous junction. Although the natural history of the diaphragmatic injury is unknown, some animal studies have shown that it might heal without development of hernia (14, 15). If diagnosis of the injury is missed after the first admission, patients may be asymptomatic or have intermittent chronic abdominal or respiratory symptoms due to increased intra-abdominal pressure including constipation, cough, or distension after heavy meal.…”

Section: Discussionmentioning

confidence: 99%

Blunt Traumatic Hernia of Diaphragm With Late Presentation

et al. 2012

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BackgroundDiaphragmatic hernia after blunt trauma is an uncommon and often undiagnosed condition.ObjectivesWe aimed to review patients who presented with delayed blunt traumatic hernia of diaphragm.Patients and MethodsIn this retrospective study, the medical records of six patients treated for blunt diaphragmatic hernias who were admitted to Kashan Shahid Beheshti hospital between June 2007 and June 2011 were analyzed.ResultsSix patients with mean age of 41 years were included in the study. Male to female ratio was 2:1. Mean duration between trauma and admission to the hospital was 6.5 years (2 – 26 years). Five patients had left-sided diaphragmatic hernia. Chest X-ray was obtained from all patients which was diagnostic in 50 percent of the cases (n = 4). Additional diagnostic imaging with computerized tomography (CT) was used in six patients and upper gastrointestinal (GI) contrast study was performed in one patient. All patients underwent thoracotomy incision. Mesh repair was utilized in one patient. The mean hospitalization time was 14.1 days. There was one postoperative death (16.7%).ConclusionsLate presentation of blunt diaphragmatic hernia is an uncommon and challenging situation for the surgeon. Prompt diagnosis and treatment prevent serious morbidity and mortality associated with complications such as gangrene and perforation of herniated organ.

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Section: Discussionmentioning

confidence: 99%

Blunt Traumatic Hernia of Diaphragm With Late Presentation

et al. 2012

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“…In patients with no hollow viscous injury, vascular injury, or a clear indication for laparotomy, selective nonoperative management of thoracoabdominal penetrating injury might be associated with lower morbidity and a high success rate [ 13 , 14 ]. Currently, there is no consensus in regard to the repair of the right diaphragm injury and it is believed to have minimal consequences and "protection" from herniation by the large fixed liver, as supported by animal experimental studies with strong evidence of spontaneous healing in more than 90% of injuries [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Nonoperative Management of Penetrating Right Thoracoabdominal Injury

Ahmed

Mikael

Gorski

et al. 2021

Cureus

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“…Whilst is has been proposed the right-sided diaphragmatic injuries are less severe because the liver acts to “protect” the defect and prevent delayed herniation of abdominal contents, this theory may not be universally true. [62] Overall, right-sided TAA gunshot injuries account for <7% of all abdominal GSWs. [63] Non-surgical approach to this particular injury complex can be attributed to the frustration caused by reportedly avoidable operations on nonbleeding injuries isolated to the liver.…”

Section: Thoracoabdominal Woundsmentioning

confidence: 99%

Trends in nonoperative management of traumatic injuries – A synopsis

Stawicki

2017

Int J Crit Illn Inj Sci

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Nonoperative management of both blunt and penetrating injuries can be challenging. During the past three decades, there has been a major shift from operative to increasingly nonoperative management of traumatic injuries. Greater reliance on nonoperative, or “conservative” management of abdominal solid organ injuries is facilitated by the various sophisticated and highly accurate noninvasive imaging modalities at the trauma surgeon’s disposal. This review discusses selected topics in nonoperative management of both blunt and penetrating trauma. Potential complications and pitfalls of nonoperative management are discussed. Adjunctive interventional therapies used in treatment of nonoperative management-related complications are also discussed.Republished with permission from:Stawicki SPA. Trends in nonoperative management of traumatic injuries – A synopsis. OPUS 12 Scientist 2007;1(1):19-35.

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Penetrating Trauma to the Diaphragm

Cited by 29 publications

References 21 publications

Blunt Traumatic Hernia of Diaphragm With Late Presentation

Blunt Traumatic Hernia of Diaphragm With Late Presentation

Nonoperative Management of Penetrating Right Thoracoabdominal Injury

Trends in nonoperative management of traumatic injuries – A synopsis

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