[Blunt and penetrating diaphragmatic injuries]

Between 1987 and 1992, 17 patients sustaining injury of the diaphragm were treated at our institution. All patients had associated injuries. Blunt diaphragmatic rupture (n = 13) was mostly diagnosed by chest X-ray, additional diagnostic procedures (contrast radiography, sonography) confirmed a suspected diaphragmatic rupture. In all 4 cases with penetrating injury the diagnosis was found by explorative laparotomy. In 2 patients sustaining blunt diaphragm rupture the diagnosis was delayed by 2 and 6 days. 3 patients (all sustaining blunt diaphragm rupture) died related to their associated injuries. All patients sustaining blunt or penetrating thoracoabdominal trauma, specially in high-velocity road accidents and injuries by shots or knives, are suspicious for diaphragmatic injury.