A Clinical Analysis of Traumatic Diaphragmatic Rupture.
- Author:
Won Geon LEE
1
;
In Suk SOUNG
;
Jin Sang LIM
;
Sung Chul KIM
;
Kwang Tae KIM
Author Information
1. Department of Surgery, Dae Rim Saint Mary's Hospital, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Diaphragmatic rupture;
Traumatic
- MeSH:
Abdominal Pain;
Cause of Death;
Chest Pain;
Colon;
Dyspnea;
Early Diagnosis;
Female;
Humans;
Laparotomy;
Male;
Mortality;
Postoperative Complications;
Rupture*;
Saints;
Shock;
Shock, Septic;
Spleen;
Thoracotomy;
Thorax
- From:Journal of the Korean Surgical Society
1998;55(3):368-374
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A clinical analysis was made of 18 cases of traumatic diaphragmatic rupture which had been treated during the 8 years from January 1989 to December 1997 at the Department of Surgery & Chest Surgery, Dae Rim Saint Mary's Hospital. The results are as follows: 1) The most common ages were 3rd and 4th decades (61.1%).There were 14 males and 4 females (M : F = 3.5 : 1) 2) The traumatic diaphragmatic ruptures were due to blunt trauma in 13 (72.2%) patients (left 10, right 3) and penetrating trauma in 5 (27.8%) patients (left 5). 3) The common symptoms were dyspnea (77.8%), abdominal pain (66.7%), and chest pain (55.6%). 4) 12 of the 18 patients were diagnosed before operation. Six patients were diagnosed during operation. 5) 15 of the 18 patients were operated on within 24 hours (83.3%). 6) The most common associated intraabdominal injured organ was spleen (44.4%). The most common herniated organ was colon (27.8%). 7) Most of the injuries ranged in size from 6 to 10 cm in the blunt trauma patients (53.8%) and less than 5 cm in penetrating trauma patients (100%). 8) The operations were done using a laparotomy alone in 11 patients, a thoracotomy in 5 patients, and a thoracoabdominal incision in 2 patients. 9) Postoperative complications were developed in 8 patients (44.4%). 10) The perioperative mortality was 11.1%, and the causes of deaths were hypovolemic shock and septic shock. In conculusion, traumatic diaphragmatic rupture without severe associated organ injury could reveal a good outcome, if early diagnosis and proper treatment was performed.
