Thoracic trauma: principles of early management

Tai, Nigel; Boffard, Kenneth D.

doi:10.1191/1460408603ta277oa

Cited by 11 publications

(8 citation statements)

References 87 publications

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“…[ 4 ] Contrast studies are valuable only in cases of DI with chronic, longstanding herniations of intra-abdominal viscera. [ 1 14 ] One study describes the successful use of intraperitoneal technetium to diagnose a suspected rightsided diaphragmatic tear. [ 4 ] The diagnostic peritoneal lavage has been used to detect DI in several studies but resulted in falsenegative rates as high as 25-35% when studied retrospectively.…”

Section: Discussionmentioning

confidence: 99%

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Treating traumatic injuries of the diaphragm

Dwivedi

Banode

Gharde

et al. 2010

J Emerg Trauma Shock

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Traumatic diaphragmatic injury (DI) is a unique clinical entity that is usually occult and can easily be missed. Their delayed presentation can be due to the delayed rupture of the diaphragm or delayed detection of diaphragmatic rupture, making the accurate diagnosis of DI challenging to the trauma surgeons. An emergency laparotomy and thorough exploration followed by the repair of the defect is the gold standard for the management of these cases. We report a case of blunt DI in an elderly gentleman and present a comprehensive overview for the management of traumatic injuries of the diaphragm.

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Section: Discussionmentioning

confidence: 99%

“…Laparoscopy allows assessment and repair of the diaphragm. [ 1 14 ] If open surgery is not required, suspected patients should undergo either diagnostic laparoscopy or video-assisted thoracoscopy. [ 5 ] Thoracoscopy is probably more useful in obvious thoracic injuries and in right-sided penetrating thoracoabdominal injuries.…”

Section: Discussionmentioning

confidence: 99%

Treating traumatic injuries of the diaphragm

Dwivedi

Banode

Gharde

et al. 2010

J Emerg Trauma Shock

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“…In addition, the following six injuries may be delayed or masked by other injuries (the hidden six): trachea-bronchial disruption, pulmonary contusion, traumatic disruption of the aorta, blunt cardiac injury, esophageal perforation, and diaphragmatic tear [8]. Accurate assessment of a trauma patient at high risk for major potentially life-threatening chest injuries is critical.…”

mentioning

confidence: 99%

Prevalence and Pattern of Chest Trauma in Saudi Arabia: a Single-Center Experience.

Al-Mourgi¹,

Abdelrhman²,

Hussein³

et al. 2016

IJAR

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Background: Chest injuries are one of the common causes of mortality and morbidity. Aim: our aim was to analyze the prevalence, pattern, severity, and management of chest injuries and to outline the outcome and the prognosis in our local setting. Methods: We conducted this retrospective study in King AbdulAziz Specialist Hospital, Taif, (KSA). A total of 226 patients who presented to the ER with chest injuries were included in the study. The data collected and entered into the proforma. Results: The highest rate of injuries was observed in the age group of 21-30 years old. Most patients were male (87.2%) and involved in RTAs (86.7%). The most common clinical type of chest injury was lung contusion, followed by rib fractures and pneumo-thorax. Head trauma was the most common extra-thoracic injury, followed by injury to the extremities. 75.2% of patients were managed conservatively, 25.2% % required tube thoracostomy, while 1.8% required thoracotomy. Length of hospital stay was increased in patients with extra-thoracic injuries and those who were intubated. Conclusion: RTAs constitute the leading cause of chest trauma in our locality. Establishing a national chest trauma database is an essential step toward decreasing the burden of traumatic chest injuries.

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“…The repair can be done by Open as well as by Minimal Invasive Surgery. The abdominal or thoracic route may be used for the exploration of diaphragm [13,14]. The basic principle to repair diaphragmatic repair is proper visualization of the defect by transecting the falciform ligament and downward retraction of liver to get access over right hemidiaphragm along with retraction over spleen and greature curvature of the stomach to visualize the left hemidiaphragm.…”

Section: Discussionmentioning

confidence: 99%

Double Blow Injury: Diaphragmatic Rupture with Gastric Perforation Following Blunt Trauma

Paswan

Kumar

Chitta

et al. 2019

SN Compr. Clin. Med.

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Diaphragmatic injury is an unusual life threatening complication of blunt trauma abdomen. However, a double blow injury occurring simultaneously such as diaphragmatic hernia and gastric injury is a rare injury. The association of gastric perforation along with diaphragmatic injury increases the mortality as well as morbidity manifold as compared to an isolated diaphragmatic injury. Traumatic diaphragmatic injury has variable clinical presentation ranging from pain in abdomen to respiratory distress and pneumonia. Preoperative diagnosis of diaphragmatic injury is quite demanding and often it goes undetected only to be found later intraoperatively. Although chest X-ray is still the best screening imaging modality to detect the diaphragmatic hernia but occasionally, especially for right-sided diaphragmatic injury, computed tomography and magnetic resonance imaging may be required to detect it in early stage. Here, we report a case of diaphragmatic hernia with gastric perforation sustaining blunt trauma in an 18 years old, young adult. Only a few cases of double blow injury with perforation of the diaphragm and stomach are reported in the literature. We aim to report this case because a prompt intervention with high degree of suspicion is the key to success in managing diaphragmatic hernia with gastric perforation following blunt trauma injury to the abdomen.

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Thoracic trauma: principles of early management

Cited by 11 publications

References 87 publications

Treating traumatic injuries of the diaphragm

Treating traumatic injuries of the diaphragm

Prevalence and Pattern of Chest Trauma in Saudi Arabia: a Single-Center Experience.

Double Blow Injury: Diaphragmatic Rupture with Gastric Perforation Following Blunt Trauma

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