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          VOLUME 37 / ISSUE 3

The Journal is Indexed in

4 - Traumatic diaphragm ruptures

Halil Coşkun, Uygar Demir, Ali Kalyoncu, Tülay Eroğlu, Suat Evirgen, Mehmet Mihmanlı

Objective: Traumatic diaphragm rupture is an easily missed complication following blunt or penetrating thoracoabdominal injury. Missing of diaphragm ruptures, increases the related complications, morbidity and mortality.

Study Design: Between January 1998 - January 2003, 10 patients whom were operated due to traumatic diaphragm rupture were evaluated according to age, gender, occurrence of trauma, clinical symptoms, diagnostic assays, accompanying pathologies, operative findings, repair technique, morbidity and mortality.

Results: Nine cases were male and one was female, with a median age of32 (25-44) years. Occurence of the trauma and accompanying organ injuries are; 6 cases were penetrating injury (3 cases of gunshot wounds with liver and spleen injury, 2 cases of stab wounds with liver and 1 case of stab wound with spleen, small bowel injury), 4 cases were blunt trauma due to traffic accident (2 cases with spleen injury and 2 cases with spleen, small bowel injury). The accurate diagnosis was made in the first attendance in 9 cases and 48 hours after in one case. Laparotomy was performed in all cases without necessity for thoracotomy and diaphragm was primarily repaired in all cases. Two cases had pleural effusion after the operation. All patients have discharged from hospital without complication. Median hospital stay is 9.2 days, mean follow- up period is 10 months.

Conclusions: The traumatic rupture of the diaphragm, can easily be missed during the acute period of the trauma. The main and valuable diagnostic tool is PA chest X-ray.Diagnostic laparoscopy could be performed for evaluation and treatment. The main point for its diagnosis is the consideration of its existence.

Keywords: Diaphragma ruptures, trauma.

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