Related Experiment Videos
[Blunt diaphragmatic rupture in children]
S Belgerden1, C Ertekin, S Yamaner
1Chirurgische Notfallabteilung, Medizinischen Fakultät, Universität Istanbul.
Insights
Blunt traumatic diaphragmatic hernia is an uncommon pediatric injury. This study highlights its increased incidence, diagnostic challenges, and high mortality rate in children following trauma.
Area of Science:
- Trauma surgery
- Pediatric surgery
- Emergency medicine
Context:
- Blunt traumatic diaphragmatic hernia is an uncommon but serious injury in children.
- Increased incidence linked to rising rates of automobile and pedestrian accidents.
- This study reviews 9 pediatric cases over a 5-year period.
Purpose:
- To analyze the incidence, diagnosis, management, and outcomes of traumatic diaphragmatic hernia in pediatric patients.
- To highlight the diagnostic challenges and associated injuries in pediatric blunt trauma.
- To report on surgical repair and mortality rates.
Summary:
- Nine pediatric patients (3-14 years) with acute diaphragmatic rupture from blunt trauma were treated.
- Diagnosis involved chest X-ray and laparotomy for hemoperitoneum; hypotension was common.
- All diaphragmatic tears were repaired surgically, with a significant mortality rate of 33.3%.
Impact:
- Underscores the severity of blunt diaphragmatic injuries in children.
- Emphasizes the need for prompt diagnosis and surgical intervention.
- Highlights the high mortality associated with these injuries and associated complications.
Abstract:
The incidence of traumatic diaphragmatic hernia due to blunt trauma, an uncommon injury in children, has been increased with the increase in automobile and pedestrian accidents. During a 5 year period, 9 patients 3-14 years of age, with acutely ruptured diaphragms following blunt trauma were treated in our institution. Diaphragmatic injury was detected within 6 hours of admission to the hospital. In 2 patients the diagnosis was suggested by upright chest X-ray. In the remaining 7 patients, the diaphragmatic ruptures were diagnosed at laparotomy performed for hemiperitoneum diagnosed by peritoneal lavage. At initial evaluation hypotension was present in all but one patient. Intraabdominal organs were herniated through the diaphragmatic defect in 3 patients. All patients had associated extraabdominal injuries and 90% had associated intraabdominal injuries. The diaphragmatic tear was repaired via abdomen in all patients and all defects were closed primarily. The mortality rate was 33.3%. Early deaths were attributable to hemorrhage and severe head injury, the single late death to sepsis and progressive multiorgan-failure.