Delayed diagnosis of traumatic diaphragmatic rupture

Mizobuchi, Teruaki; Iwai, Naomichi; Kohno, Hiromasa; Okada, Nao; Yoshioka, Tomoki; Ebana, Hiroki

doi:10.1007/s11748-009-0418-0

Cited by 14 publications

(17 citation statements)

References 5 publications

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“…Video-assisted thoracoscopy is also a useful explorative and eventually therapeutic tool for diaphragmatic lesions. Traumatic diaphragmatic lesions are more common than believed and can be misdiagnosed very easily, thus leading to delayed complications (28). A thoracoscopic evaluation of the pleural cavity can demonstrate easily misdiagnosed lesions and treat a possible persisting haemothorax.…”

Section: Surgical Trauma Life Supportmentioning

confidence: 99%

Management of chest trauma

Ludwig¹,

Koryllos²

2017

J. Thorac. Dis.

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Trauma is the leading cause of death worldwide. Approximately 2/3 of the patients have a chest trauma with varying severity from a simple rib fracture to penetrating injury of the heart or tracheobronchial disruption. Blunt chest trauma is most common with 90% incidence, of which less than 10% require surgical intervention of any kind. Mortality is second highest after head injury, which underlines the importance of initial management. Many of these deaths can be prevented by prompt diagnosis and treatment. What is the role of the thoracic surgeon in the management of chest trauma in severely injured patients? When should the thoracic surgeon be involved? Is there a place for minimal invasive surgery in the management of severely injured patients? With two case reports we would like to demonstrate how the very specific knowledge of thoracic surgeons could help in the care of trauma patients.

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Section: Surgical Trauma Life Supportmentioning

confidence: 99%

Management of chest trauma

Ludwig¹,

Koryllos²

2017

J. Thorac. Dis.

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“…Cases of traumatic DI appearing up to 20 years after the injury have been published with some of them diagnosed accidentally. [4][5][6][7][8] Patients may present with nonspecifi c symptoms and may complain of chest pain, abdominal pain, dyspnea, tachypnea, or cough symptoms and signs due to the herniation of abdominal contents into the thorax. In our case, the patient, although sustaining a high-energy road traffi c accident, did not ask for any medical assistance for 2 weeks and eventually appeared complaining of thoracic pain and dyspnea.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 Video-assisted thoracoscopic surgery can be an adequate method of evaluating the diaphragm instead of a laparotomy. 3,6 Laparoscopy and/or thoracoscopy are considered acceptable tools for the diagnosis and repair of a missed diaphragmatic injury. 14…”

Section: Discussionmentioning

confidence: 99%

“…Although it is considered an emergency entity, rare cases of this injury appearing many years later have been published. [4][5][6] We herein present the case of a 56-year-old man who had sustained isolated right diaphragm rupture after blunt thoracic trauma that was diagnosed 2 weeks after the injury when he eventually presented to a medical facility.…”

Section: Introductionmentioning

confidence: 99%

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Isolated right diaphragmatic rupture following blunt trauma

Baloyiannis

Kouritas

Karagiannis

et al. 2011

Gen Thorac Cardiovasc Surg

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Blunt diaphragmatic injuries are usually caused by blunt trauma or penetrating injuries. The diagnosis may be delayed or missed because of the confusing clinical and radiographic findings and the presence of multiple associated injuries. We report the case of an isolated right diaphragm rupture in a 56-year-old man who sustained blunt thoracic trauma after car accident 2 weeks before presentation. No other injuries were detected, and he was subjected to laparotomy. Diaphragmatic rupture is perceived as an emergency entity. The late appearance of such an injury, without other accompanying injuries, is rare and should be in mind by clinicians treating trauma patients who have a delayed presentation after the injury.

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“…Diyafragma rüptürleri, penetran veya künt torakoabdominal travmaların %0, 6'sı ve tüm vücut travmalarının %4,5-6'sında görülmektedir (3,4). Tanısının zor olması nedeni ile akut dönemde hastaların gözden kaçırılması kolay olabilmektedir (5). Bu hastaların tanı konma süreleri birkaç günden birkaç yıla kadar uzayabilir (6).…”

Section: Introductionunclassified

Late Complication In Patient With Traumatic Diaphragmatic Defect: Internal Hernia

Sert¹,

Salimoğlu²,

Karadeniz³

et al. 2011

Tepecik Dergisi

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ÖZETBu makalede penetran toraks travması geçiren ve 9 ay sonra travmatik diyafragma hernisi tanısı konan 29 yaşında bir erkek hasta sunulmuştur. Dokuz ay önce konservatif olarak tedavi edilen ve barsak tıkanıklığı yakınmalarıyla acile gelen hastada Bilgisayarlı Tomografide sol hemitoraksta abdominal organların oluşturduğu hava-sıvı seviyesi görüldü. Abdominal eksplorasyonda, sol diyafragmada 10 cm'lik iki ayrı diyafragma defekti vardı. Midenin; medyal defekten, transvers kolon, omentum ve dalağın; lateral diyafragma defektinden fıtıklaştığı görüldü. Bu olgu sunumun künt veya penetran karın ve toraks travması geçirmiş hastalarda diyafragma yaralanması olasılığını hatırlatacağına inanıyoruz.Anahtar Sözcükler: fıtık, diyafragma, toraks travması, ileus SUMMARY A 29 year old male patient who experienced penetrating thoracic trauma and had diagnosis of traumatic diaphragmatic hernia nearly 9 months later is presented here. Nine months before the patient was managed conservatively. The patient was referred to our emergency room complaining of intestinal obstruction symptoms. Computed tomography scan revealed fluid level formed by the abdominal organs in the left hemi-thorax. During abdominal exploration, two different 10cm of diaphragmatic defects located in left diaphragm were seen. Stomach was found to be herniated through the medial defect and transverse colon, omentum and spleen were herniated through the lateral diaphragmatic defect. We believe that this case report serves a useful reminder suspicion for diaphragmatic injuries in patients with a history of blunt or penetrating thoracic trauma.

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Delayed diagnosis of traumatic diaphragmatic rupture

Cited by 14 publications

References 5 publications

Management of chest trauma

Management of chest trauma

Isolated right diaphragmatic rupture following blunt trauma

Late Complication In Patient With Traumatic Diaphragmatic Defect: Internal Hernia

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