Traumatic rupture of the diaphragm: Experience with 112 patients

Le résumé fourni par la source

Traumatic diaphragmatic rupture is reported with increasing frequency and is associated with high morbidity and mortality. The purpose of this study was to present our experience with the management of this injury,112 patients with TDR were treated in our hospital between January 1989 and Dicember 2011. They were 89men (79,46%) and 23 women (20,5%). Mean age was 36.57 years (range 15-76 years). Rupture of the diaphragm was left-sided in 74 patients (67%), right-sided in 35 (31,25%), and bilateral in 3 (2,6%). Blunt trauma accounted for the injuries of 89 patients (79,46%). Early diagnosis was obtained in 98 patients (87,5%). The diagnosis was established preoperatively in 29 patients (25,83%), and intra-operatively in 83 (74,1%). Multiple associated injuries were observed in 106 patients (94,64%). Postoperative complications were observed in 12 (10,71%), and the overall mortality was 14%. Injury severity score (ISS) and haemorrhagic shock upon admission strongly influence the outcome. A high index of suspicion and a thorough examination of both hemi diaphragms during laparotomy is recommended in order to avoid early or late complications.

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