Traumatic diaphragmatic rupture with combined thoracoabdominal injuries: Difference between penetrating and blunt injuries

Jin-mou, Gao; Du, Dingyuan; Li, Hui; Liu, Chaopu; Shaoyong, Liang; Xiao, Qiang; Zhao, Shanhong; Yang, Jun; Lin, Xi Zhang

doi:10.1016/j.cjtee.2014.07.001

Cited by 35 publications

(45 citation statements)

References 15 publications

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“…The reported incidence of TDI ranges from 0.8-7% in patients presented with blunt trauma [25] and 10-15% for penetrating injuries [19]; in our study it was 0.5% and 4%, respectively. The contemporary literature suggests that the left hemi-diaphragm is the most frequent site of diaphragmatic rupture followed by right and bilateral TDIs [1,3,21,27]. The ratio of RTDI-to-LTDI grossly varies in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Table 4 summarizes the most recent TDI studies from different countries [1,3,[14][15][16][17][18][19][20][21][22][23][24][25][26][27]. However, we may underestimate the incidence of TDI as the majority of mild (missed) or severe (died before diagnosis) lesions can be difficult to diagnose or because of the unavailability of routine postmortem examination in the state of Qatar.…”

Section: Discussionmentioning

confidence: 99%

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Descriptive Analysis of Right and Left-sided Traumatic Diaphragmatic Injuries; Case Series from a Single Institution

Al-Thani

Jabbour

El‐Menyar

et al. 2018

BEAT

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Objective: To investigate the presentation, management and outcomes of left and right-sided traumatic diaphragmatic injury (TDI) in a single level I trauma center. Methods: This cross-sectional study was conducted during a 7-year period from 2008 to 2015 in a level I trauma center in Qatar. We included all the patients who presented with TDIs during the study period. Data included demographics, mechanism of injury, associated injuries, initial vitals, emergency department disposition, length of ICU and hospital stay, ventilator days, management, and outcomes. The variables were analyzed and compared for patients with left (LTDI) and right (RTDI). Results: A total of 52 TDI cases (79% LTDI and 21% RTDI) were identified with a mean age of 31±11. LTDI patients were more likely to have higher Injury severity scores (p=0.50) and greater AAST organ injury scoring (p=0.661 for all) than RTDI patients. Surgical repair was performed for 85% LTDI vs. 73% RTDI (p= 0.342). Recurrent DIs was reported only in LTDI (5.1% vs. 0.0%; p=0.911). Twelve patients died (9 LTDI and 3 RTDI), of them 5 had associated head injury. Conclusion: This single-institution study confirms that LTDI are more commonly diagnosed than RTDI. Exploratory laparotomy is the most frequent procedure considered for the management of diaphragmatic injuries in the emergency settings. To improve outcomes in patients presenting with TDI, large prospective multicenter studies are needed to standardize the TDI management protocols including the diagnostic workup, timing of surgical intervention, and the most appropriate approach of treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Descriptive Analysis of Right and Left-sided Traumatic Diaphragmatic Injuries; Case Series from a Single Institution

Al-Thani

Jabbour

El‐Menyar

et al. 2018

BEAT

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“…The comparison between the abdominal and thoracic approach in chronic lesions in percentage is shown in Figure 4C. Thoracotomy Abdominal approach with requirement for thoracic assess: only six studies 1,12,27,39,63,66 reported abdominal onset in a total of 385 patients, with subsequent need for thoracic cavity opening in 39 of them (10% CI 95% 8-14%) ( Figure 5A). …”

Section: Synthesis Of Resultsmentioning

confidence: 99%

Thoracotomy compared to laparotomy in the traumatic diaphragmatic hernia. Systematic review and proportional methanalysis

Silva

Catâneo

2018

Acta Cir. Bras.

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Purpose: To evaluate the most used approach to treat traumatic diaphragmatic ruptures, and in which one the requirement to assess the second cavity is more frequent. Methods: Systematic review, observational studies. Outcomes: moment of approach, most commonly via addressed and the requirement to open the other cavity. Bases searched: Lilacs, Pubmed, Embase, Clinicaltrials.gov and Web of Science. Statistical analysis: StatsDirect 3.0.121 software. Results: Sixty eight studies (2023 participants) were included. Approach in acute phase was performed four times more than in chronic phase. Approach: abdominal 65% (IC 95% 63-67%), thoracic 23% (IC 95% 21-24%), abdominal in the acute phase 75% (IC 95% 71-78%), and chronic 24% (IC 95% 19-29%), thoracic in the acute phase 12% (IC 95% 10-14%) and chronic 69% (IC 95% 63-74%). Thorax opening in the abdominal approach: 10% (95% CI 8-14%). Abdomen opening in the thoracic approach: 15% (95% CI 7-24%). Conclusions: The most common approach was the abdominal. The approach in the acute phase was more common. In the acute phase the abdominal approach is more frequent than the thoracic approach. In the chronic phase the thoracic approach is more frequent than the abdominal one. The requirement to open the second cavity was similar in both approaches.

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“…Причинами возникновения посттравматической диафрагмальной грыжи являются открытая или закрытая травма грудной клетки и живота, торако-абдоминальное ранение и ятрогенные повреждения [2,10,12,14,18]. Некоторыми авторами используется понятие «ложная грыжа», из-за того, что эта грыжа не всегда имеет грыжевой мешок [3].…”

Section: Introductionunclassified

“…Некоторыми авторами используется понятие «ложная грыжа», из-за того, что эта грыжа не всегда имеет грыжевой мешок [3]. Чаще оказывается повреждённым левый купол диафрагмы, а право-сторонняя локализация дефекта составляет лишь 11-14 % [1,3,4,12,14,15,19].…”

Section: Introductionunclassified

Posttraumatic Diaphragmatic Hernia (Diagnostics and Treatment)

Чикинев¹,

Chikinev²,

Дробязгин³

et al. 2017

Acta Biomedica Scientifica

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Traumatic diaphragmatic rupture with combined thoracoabdominal injuries: Difference between penetrating and blunt injuries

Cited by 35 publications

References 15 publications

Descriptive Analysis of Right and Left-sided Traumatic Diaphragmatic Injuries; Case Series from a Single Institution

Descriptive Analysis of Right and Left-sided Traumatic Diaphragmatic Injuries; Case Series from a Single Institution

Thoracotomy compared to laparotomy in the traumatic diaphragmatic hernia. Systematic review and proportional methanalysis

Posttraumatic Diaphragmatic Hernia (Diagnostics and Treatment)

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