Blunt diaphragmatic rupture in children.
BACKGROUND
Although several series of blunt diaphragmatic rupture in adults have been published, this injury remains largely uncharacterized in the pediatric population.


METHODS
We queried our trauma registry for all children admitted with blunt diaphragmatic rupture over a 10-year period at a Level I pediatric trauma center.


RESULTS
Six children (aged 2-15 years; mean, 7 years) were identified with blunt diaphragmatic rupture (three right, two left, one bilateral), representing 0.4% of admissions. All of the children had associated injuries (4.5 per child), with a mean Injury Severity Score of 32. Four diaphragmatic injuries were identified during the initial evaluation. The two missed injuries were diagnosed at postinjury days 5 and 8. There were no deaths and all children were eventually discharged without sequelae.


CONCLUSIONS
Blunt diaphragmatic rupture occurs in children with a frequency and severity commensurate with that observed in adults. Our data suggest improved survival compared with adults with this injury.
Barsness
Katherine A
KA
Division of Pediatric Surgery, The Children's Hospital, Denver, CO 80262, USA. katherine.barsness@uchsc.edu
Bensard
Denis D
DD
Ciesla
David
D
Partrick
David A
DA
Hendrickson
Richard
R
Karrer
Frederick M
FM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003120:Colorado / Q000453:epidemiology; D003964:Diaphragm / Q000293:injuries*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology; D012189:Retrospective Studies; D012421:Rupture / Q000145:classification / Q000175:diagnosis; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014949:Wounds, Nonpenetrating / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology