title: Traumatic perforation of the diaphragm.
abstract: To ascertain our experience with traumatic perforations of the diaphragm, we reviewed the charts of 72 patients treated over a ten-year period. From January 1975 through June 1984, 58 male patients and 14 female patients, ranging in age from 6 to 72 years, were treated for traumatic perforations of the diaphragm. These injuries resulted from gunshot wounds in 44 patients (61%), stab wounds in 13 (18%), blunt trauma in 11 (15%), and shotgun wounds in four (6%). Seventy-three percent of the injuries were to the left hemidiaphragm, 26% to the right, and 1% to both. Signs and symptoms were unreliable for making the diagnosis of perforation. Diagnosis depended mainly on preoperative chest roentgenograms (especially for those caused by blunt trauma), thorough intraoperative exploration, and a high index of suspicion. Overall mortality was 7%, but death was usually more readily attributable to associated injuries than to the diaphragmatic injuries.
authors.affiliation: Department of General Surgery, Charlotte Memorial Hospital and Medical Center, NC 28232.
authors.forename: N L
authors.initials: NL
authors.lastname: Pipkin
authors.forename: H F
authors.initials: HF
authors.lastname: Hamit
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012421:Rupture; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery; D014950:Wounds, Penetrating / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000601:surgery