Traumatic diaphragmatic rupture: look to see
Kutsal Turhan1, Ozer Makay, Alpaslan Cakan
1Ege University Faculty of Medicine, Department of Thoracic Surgery, Bornova 35100, Izmir, Turkey. kutsal.turhan@ege.edu.tr
Summary
Traumatic diaphragmatic rupture (TDR) is a rare injury, often missed, with frequent associated trauma. Prompt surgical repair is crucial for patient outcomes.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Emergency Medicine
Background:
- Traumatic diaphragmatic rupture (TDR) is a rare clinical entity.
- TDR often presents with associated injuries, complicating diagnosis and management.
Purpose of the Study:
- To present the experience with traumatic diaphragmatic rupture.
- To analyze etiological factors, management strategies, and outcomes of TDR patients.
Main Methods:
- Retrospective analysis of 68 patients operated for TDR between July 1994 and September 2005.
- Evaluation of etiological factors, surgical approaches, and patient outcomes.
Main Results:
- The majority of TDR cases resulted from penetrating trauma (75%).
- Left-sided ruptures were more common (83.8%).
- Associated injuries were present in 91% of patients, with morbidity and mortality rates of 13.1% and 16.2%, respectively.
Conclusions:
- Diaphragmatic rupture should be suspected in thoracoabdominal injuries, requiring a high index of suspicion for early diagnosis.
- Surgical repair is essential for all diaphragmatic tears.
- The transabdominal approach is favored for comprehensive abdominal exploration, while the transthoracic approach may be suitable for latent ruptures.
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