Evaluation of the multi-slice computed tomography outcomes in diaphragmatic injuries related to penetrating and blunt trauma

Turmak, Mehmet; Deniz, Muhammed Akif; Özmen, Cihan Akgül; Aslan, Aydın

doi:10.1016/j.clinimag.2017.08.010

Cited by 16 publications

(15 citation statements)

References 38 publications

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“…In left blunt TDI, the stomach and intestine are most commonly affected while in right blunt TDI, the liver is the most common. 4 This contact with the posterior ribs, deemed the dependent viscera sign, can be detected on CT and is suggestive of TDI. 2,32 However, the evidence for this sign varies widely in previous studies.…”

Section: Radiological Signsmentioning

confidence: 99%

“…Because penetrating TDI tears are often smaller and more difficult to identify, 2 signs have only been identified in 29.7% of such injuries. 4…”

Section: Radiological Signsmentioning

confidence: 99%

“…Additional conditions confused with TDI include diaphragmatic eventration—an abnormal area of relaxation, thinning, and hemidiaphragmatic elevation—which may be caused by phrenic nerve paresis. 10,18 The presence of a thin, smooth thoracic-abdominal boundary 4,31 distinguishes this condition from TDI. Other conditions which change the shape or continuity of the diaphragm include diaphragmatic pseudotumors, variations in diaphragmatic crura, benign diaphragmatic humps, or single hump diaphragm.…”

Section: Radiological Signsmentioning

confidence: 99%

“…Other conditions which change the shape or continuity of the diaphragm include diaphragmatic pseudotumors, variations in diaphragmatic crura, benign diaphragmatic humps, or single hump diaphragm. 4 Lung conditions such as left lower lobe atelectasis 4 as well as adjacent soft tissue injury 19 may appear similar to TDI by obscuring or distorting the hemidiaphragmatic contour. Similar findings are used for postmortem CT (PMCT) assessment of TDI.…”

Section: Radiological Signsmentioning

confidence: 99%

“…Blunt TDI affects 0.8% to 8% of patients presenting with blunt trauma, 1,2 mainly due to motor vehicle collisions (MVCs)-86% of all cases with blunt TDI, 3 blunt TDI can be iatrogenic or as a consequence of pregnancy. 4 On the other hand, penetrating TDI affects 10% to 15% of patients presented with penetrating wounds from stab and firearm injuries. 1 Interestingly, about 12% to 63% of TDIs are undiagnosed at initial presentation, [5][6][7][8][9] particularly on the right side.…”

mentioning

confidence: 99%

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Unravelling the Mysteries of Traumatic Diaphragmatic Injury: An Up-to-Date Review

et al. 2020

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Traumatic diaphragmatic injury (TDI) is an underdiagnosed condition that has recently increased in prevalence due to its association with automobile collisions. The initial injury is often obscured by concurrent thoracic and abdominal injuries. Traumatic diaphragmatic injury itself is rarely lethal at initial presentation, however associated injuries and complications of untreated TDI such as herniation and strangulation of abdominal viscera have serious clinical consequences. There are 2 primary mechanisms of TDIs: penetrating TDI which tend to be smaller, more difficult to detect, and result in fewer complications; and blunt TDIs which are larger and have higher overall mortality due to associated injuries or delayed complications. The anatomy of thoracic and abdominal cavities distinguishes the epidemiology, pathophysiology, symptoms, treatment, and prognosis of right versus left TDI. Although there is no definitive radiologic sign for diagnosing TDI, many signs have been introduced in the literature and the concurrent presence of multiple signs increases the sensitivity of TDI detection. Conservative versus surgical management depends on mechanism of TDI, side, and most importantly the associated injuries.

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Section: Radiological Signsmentioning

confidence: 99%

“…Because penetrating TDI tears are often smaller and more difficult to identify, 2 signs have only been identified in 29.7% of such injuries. 4…”

Section: Radiological Signsmentioning

confidence: 99%