[Intraoperative sonography to exclude thoracic injury].

Area of Science:

• Trauma Surgery
• Diagnostic Imaging
• Surgical Innovation

Background:

• Abdominal stab wounds can lead to severe complications, including diaphragmatic injuries.
• Hypovolemic shock necessitates rapid surgical intervention (laparotomy).
• Assessing diaphragmatic integrity post-trauma can be challenging.

Observation:

• A 29-year-old female presented with an abdominal stab wound and hypovolemic shock.
• Laparotomy revealed splenectomy and gastric suture were required.
• A left diaphragmatic wound was noted, with unclear penetrating status.

Findings:

• Intraoperative ultrasonography was utilized to assess the diaphragmatic wound from the abdominal cavity.
• The ultrasonography was performed using a sterile-covered transducer and acoustic gel.
• This imaging modality effectively excluded any intrathoracic injury adjacent to the diaphragm.

Implications:

• Intraoperative ultrasonography offers a non-invasive method to evaluate diaphragmatic injuries during laparotomy.
• It can help avoid unnecessary exploratory thoracotomy, reducing patient morbidity.
• This technique enhances diagnostic accuracy in complex trauma cases involving the diaphragm.