Management of Traumatic Diaphragmatic Rupture

Hacıibrahimoğlu, Gökhan; Solak, Okan; Olcmen, Aysun; Bedirhan, Mehmet Ali; Solmazer, Nur; Gürses, Atilla

doi:10.1007/s00595-003-2662-8

Cited by 78 publications

(59 citation statements)

References 15 publications

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“…In my opinion, the method of suture is crucial for recurrence rates. The diaphragmatic defects should be repaired with nonabsorbable Bfigure-of-eight suture.^When the defect is large, mesh repair is needed to complete tension-free repair [14,15]. Long-term follow-up with radiological imaging and ultrasonography are also required to monitor the recurrence of diaphragmatic hernia.…”

Section: Discussionmentioning

confidence: 99%

Thoracotomy for Traumatic Diaphragmatic Hernia

Zhang¹,

Zheng

Chun

et al. 2016

Indian J Surg

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The aim of this retrospective study is to review our experience in the diagnosis and role of thoracotomy for traumatic diaphragmatic hernia (TDH). Between January 2008 and June 2014, 23 patients from Yangzhou Medical College (Yangzhou China) and Lishui Center Hospital (Lishui China), who underwent thoracotomy for TDH, were analyzed. The clinical features, imaging findings, operative findings, and outcome of treatment in these patients are presented. There were 23 patients (18 males and 5 females) who underwent surgical procedures due to TDH. The median age of the patients was 43.2 years (range, 15-68 years). The cause of rupture was penetrating trauma in 1 (4.3 %) patient and blunt trauma in 22 (95.7 %) patients. The TDH was left sided in 21 patients and right sided in two patients. The diagnosis was made by chest X-ray (n = 2) and chest or abdominal CT (n = 13) and at thoracotomy based on a high index of suspicion (n = 8). Associated injuries were seen in 21 patients (91.3 %). Twenty-two patients underwent thoracotomy, and one underwent thoracotomy with laparotomy. The mean operating time was 112 min (range, 60-185 min) and the mean blood loss was 116 mL (range, 20-400 mL). The most common herniated organs were the omentum (n = 15), stomach (n = 14), spleen (n = 11), colon (n = 10), small bowel (n = 2), and liver (n = 1). All diaphragmatic defects were repaired using interrupted prolene sutures. The overall mortality rate was 4.3 % (n = 1). The diagnosis of TDH is easily missed or delayed. Chest X-ray and computer tomography (CT), especially chest and abdominal CT, are useful in the diagnosis of diaphragmatic ruptures, and thoracotomy is an effective and successful treatment for TDH.

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Section: Discussionmentioning

confidence: 99%

Thoracotomy for Traumatic Diaphragmatic Hernia

Zhang¹,

Zheng

Chun

et al. 2016

Indian J Surg

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“…A thoracotomy is preferred for all right-sided diaphragmatic defects, regardless of the timing of initial injury. 17,18 Teaching Points…”

Section: Discussionmentioning

confidence: 99%

Delayed Presentation of Diaphragmatic Rupture: An Unusual Case of Dyspnea

Ampatzidou¹,

Koutsogiannidis

Madesis

et al. 2014

Respir Care

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“…If herniation occurs, it may result in strangulation and perforation of abdominal organs, thereby increasing the rates of morbidity and mortality. Thoracotomy, laparotomy, or both are the surgical approach of choice [16]. A laparotomy is preferred for cases with an early diagnosis, as it allows surgeons to carefully explore the intra-abdominal organs for any associated injury.…”

Section: Discussionmentioning

confidence: 99%

Original article An extremely rare clinical condition: isolated post-traumatic diaphragmatic injuries

Taskesen¹,

Arıkanoğlu²,

Önder³

et al. 2012

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Aim: Isolated post-traumatic diaphragmatic injuries are observed less commonly, and the preoperative diagnosis is difficult to make. Material and methods: Thirteen patients with post-traumatic isolated diaphragmatic injury were treated in our department between January 2005 and June 2011. Age, sex, the cause, the location, the size of rupture, the severity of organ injury, the surgical materials used for repair, the associated morbidity and mortality, and the duration of hospitalization were all evaluated. Results: There were 12 male patients (92.3%) and 1 female patient (7.7%) with an overall mean age of 28.76 years (range: 15-55 years). Blunt trauma was responsible for the injuries in 4 patients (30.8%), while 9 patients (69.2%) had penetrating injuries. The diagnosis was established preoperatively in all patients (100%) via a plain chest X-ray and/or a computed tomography (CT) scan. The location of rupture was on the left side of the diaphragm in 12 patients (92.3%) and on the right side in 1 (7.7%). Isolated post-traumatic diaphragmatic rupture was repaired with interrupted nonabsorbable sutures or polypropylene mesh. Postoperative complications were observed in 2 patients (15.3%). Mortality did not occur in any of our patients. Conclusions: A meticulous physical examination and obtaining a chest X-ray should be the first steps to be taken in patients with suspicious isolated post-traumatic diaphragmatic rupture. In case of uncertainty in diagnosis, advanced modalities such as CT, ultrasonography, and magnetic resonance imaging should be utilized.

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Management of Traumatic Diaphragmatic Rupture

Cited by 78 publications

References 15 publications

Thoracotomy for Traumatic Diaphragmatic Hernia

Thoracotomy for Traumatic Diaphragmatic Hernia

Delayed Presentation of Diaphragmatic Rupture: An Unusual Case of Dyspnea

Original article An extremely rare clinical condition: isolated post-traumatic diaphragmatic injuries

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