A comparison of right and left blunt traumatic diaphragmatic rupture.
Since right blunt traumatic diaphragmatic rupture (BTDR) is reported with increasing frequency, BTDR may be a disease in evolution. Data were collected on 59 left, 16 right, and five bilateral BTDRs at a level 1 trauma center. Patients with right BTDR had lower Glasgow Coma Scale (GCS) scores (p < 0.05), were more likely to be initially in hypovolemic shock, and were admitted directly from the field (p < 0.01). Left and right BTDRs were diagnosed from chest films in 37% and 0% of cases, respectively (p < 0.05). Diagnostic peritoneal lavage results were negative in 16% of left and left of 0% of right BTDRs. For right BTDRs, the liver was more likely to be injured (p < 0.001). The mortality rates were similar and ICU and hospital stays, complications, and duration of mechanical ventilation were similar for early survivors with right and left BTDRs. The clinical signs and symptoms, diagnosis, and surgical findings associated with right and left BTDR are different.
Boulanger
B R
BR
Department of Surgery, MIEMSS, University of Maryland, Baltimore.
Milzman
D P
DP
Rosati
C
C
Rodriguez
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003964:Diaphragm / Q000293:injuries*; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008099:Liver / Q000293:injuries; D008297:Male; D008875:Middle Aged; D010533:Peritoneal Lavage; D011183:Postoperative Complications / Q000453:epidemiology; D013902:Radiography, Thoracic; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012421:Rupture; D012680:Sensitivity and Specificity; D012769:Shock / Q000209:etiology; D015996:Survival Rate; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery