• Ann Ital Chir · Sep 2006

    [Diaphragmatic traumas. Personal experience].

    • Antonino Buffone, Guido Basile, Silvana Leanza, Francesco Scirè, Antoinette Marie Bonaccorso, and Ercole Cirino.
    • Università degli Studi di Catania, Dipartimento di Chirurgia, Sezione di Chirurgia d'Urgenza, Catania. a.buffone@unict.it
    • Ann Ital Chir. 2006 Sep 1;77(5):385-9.

    ObjectiveDiaphraghmatic injuries are rare (5-7%), usually secondary to blunt, or more rarely penetrating, thoracic or abdominal trauma. The most frequent site of trauma is the left postero-lateral region. We'll try to review this pathology in all its aspects.Materials And MethodWe report our personal experience from January 2002 to December 2004 on 280 thoraco-abdominal trauma, 262 (93.5%) blunt and 18 (6.5%) penetrating, of which 5 (3.7%) interested the diaphragm. 4 following a blunt trauma and 1 an open trauma (gunshot) Each trauma was evaluated for possible associated injuries and for the type of symptoms at the admission and during the hospitalization. Preoperative diagnosis has been obtained only in 3 patients, haemodynamically stable. In the other 2 cases an emergency laparotomy was carried out because of their critic conditions and the diaphragmatic injuries were recognized during the procedure. Two patients died.ConclusionsWe remark as during the acute phase the diaphragmatic rupture may be missed because of shock, respiratory insufficiency or coma of the patient; however, it's mandatory that the right diagnosis is reached as soon as possible in order that mortality is mostly influenced by the time elapsing between trauma and diagnosis.

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