[Traumatic tear of the diaphragm]

We have carried out a 9-month retrospective study in the Emergency Resuscitation Unit; 21 patients with abdominal trauma, 42 patients with chest trauma and 895 patients with multiple injuries were treated; 197 (22%) of the latter had also chest and/or abdomen involvement. Of the 260 patients with chest and/or abdomen involvement, six (2.3%) patients had traumatic tear of the diaphragm and four of them, presented thoracic herniation of abdominal content. Diagnostic suspicion was entertained in five patients by means of x-ray plain chest film; diagnosis was confirmed by a barium meal in two patients. In one patient, the diagnosis was established perioperatively. All patients had associated lesions. Four patients required mechanical ventilation after the operation. One patient died of cardiogenic shock on the fourth postoperative day. We emphasize the importance of the suspicion of such condition in patients with multiple injuries with chest and/or abdomen involvement.