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Blunt diaphragmatic rupture.

G Beauchamp, A Khalfallah, R Girard

    American Journal of Surgery
    |August 1, 1984
    PubMed
    Summary
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    Diaphragmatic injuries in trauma patients are often missed, leading to high mortality. Early diagnosis and surgical management of diaphragmatic trauma significantly improve patient outcomes.

    Area of Science:

    • Trauma Surgery
    • Thoracic Surgery
    • Emergency Medicine

    Background:

    • Diaphragmatic injuries are frequently overlooked in polytrauma patients, contributing to elevated mortality rates.
    • A retrospective review of 32 diaphragmatic injury cases from 1970-1981 at Maisonneuve-Rosemont Hospital was conducted.

    Observation:

    • Of 32 patients, 24 sustained diaphragmatic disruption from blunt abdominal or thoracic trauma, most commonly due to motor vehicle accidents.
    • Left-sided rupture (20 cases) was more frequent than right-sided (3 cases).
    • 21 patients presented with acute diaphragmatic rupture; diagnosis was delayed in several cases, impacting outcomes.

    Findings:

    • Early diagnosis via clinical signs and radiography occurred in 15 patients.
    • Surgical approaches included abdominal (18), thoracic (4), and thoracoabdominal (2).

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  • Three patients died, with late diagnosis noted in two fatalities; 14 patients experienced no complications.

    • Implications:

    • Prompt surgical intervention for diaphragmatic trauma is crucial for successful management.
    • Diaphragmatic injury should be a primary consideration in all patients presenting with multiple trauma.
    • Early detection and treatment are key to reducing morbidity and mortality associated with diaphragmatic injuries.