title: Traumatic rupture of the diaphragm: experience with 65 patients.
abstract: 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. Sixty-five patients with TDR were treated in our hospital between January 1989 and May 2000. They were 54 men (83%) and 11 women (17%). Mean age was 36.57 years (range 15-76 years). Rupture of the diaphragm was left-sided in 43 patients (66%), right-sided in 21 (32%), and bilateral in 1 (1.5%). Blunt trauma accounted for the injuries of 52 patients (80%). Early diagnosis was obtained in 57 patients (88%). The diagnosis was established preoperatively in 17 patients (26%), and intra-operatively in 48 (74%). Multiple associated injuries were observed in 62 patients (95%). Postoperative complications were observed in seven patients (11%), 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.
authors.affiliation: Department of Thoracic Surgery, General Hospital of Attica 'KAT', 2 Nikis Street, 14561, Kifissia, Greece.
authors.forename: Peter
authors.initials: P
authors.lastname: Mihos
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Potaris
authors.forename: John
authors.initials: J
authors.lastname: Gakidis
authors.forename: John
authors.initials: J
authors.lastname: Paraskevopoulos
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Varvatsoulis
authors.forename: Basil
authors.initials: B
authors.lastname: Gougoutas
authors.forename: George
authors.initials: G
authors.lastname: Papadakis
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Lapidakis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003964:Diaphragm / Q000293:injuries* / Q000601:surgery; D005260:Female; D006549:Hernia, Diaphragmatic, Traumatic / Q000209:etiology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012421:Rupture / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000209:etiology / Q000601:surgery; D014950:Wounds, Penetrating / Q000209:etiology / Q000601:surgery