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Diaphragmatic injury in children
M L Brandt1, F I Luks, N A Spigland
1Department of Surgery, Hôpital Ste-Justine, Université de Montreal, Quebec, Canada.
The Journal of Trauma
|March 1, 1992
Summary
Diaphragmatic injuries in children are uncommon but require prompt surgical repair. Early recognition and treatment of these thoracoabdominal traumas minimize complications and ensure good patient outcomes.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Thoracic Surgery
Background:
- Diaphragmatic injuries are rare in pediatric patients.
- These injuries can result from blunt or penetrating thoracoabdominal trauma.
- Children's thoracic cage compliance may mask external injury signs.
Purpose of the Study:
- To review pediatric diaphragmatic injury cases.
- To highlight diagnostic and management strategies.
- To emphasize the importance of early surgical intervention.
Main Methods:
- Retrospective review of 13 pediatric cases (1972-1990).
- Analysis of injury mechanisms (penetrating vs. blunt trauma).
- Evaluation of associated injuries and surgical outcomes.
Main Results:
- 13 children (7 male, 6 female) aged 1-15 years treated.
- 8 penetrating and 5 blunt trauma cases.
- 9 patients had associated injuries, primarily liver trauma.
- All patients underwent exploratory laparotomy and diaphragmatic repair.
- Two deaths occurred, unrelated to diaphragmatic injury.
- All surviving patients recovered without sequelae.
Conclusions:
- Diaphragmatic injury should be suspected in pediatric thoracoabdominal trauma.
- Prompt recognition and surgical repair are crucial.
- Early intervention minimizes morbidity and mortality in pediatric diaphragmatic trauma.