[Traumatic diaphragmatic rupture. A review of seven cases].
BACKGROUND
Traumatic diaphragmatic rupture is an infrequent lesion usually found in polytrauma cases or after violent attacks. Patients are usually males between 20 and 50 years old, and car accidents are the main causes in Europe. Preoperative diagnosis must be based on a high level of suspicion and appropriate radiological explorations. Diagnostic delay is associated with high morbidity and mortality and early surgical treatment is required for successful management. We undertook this study to analyze the epidemiology of diaphragmatic rupture and to report our results in the diagnosis and treatment of this injury.


METHODS
We present seven cases from 1999 through 2005. We analyzed the reasons for admission, signs and symptoms, diagnostic approach, associated lesions, treatment and course.


CONCLUSIONS
Diagnosis of diaphragmatic rupture is difficult due to changeable symptomatology; nevertheless, it must be considered in all polytraumatized patients. Computerized tomography is the radiological exploration of choice and the most suitable surgical approach is laparotomy.
Cerdán-Pascual
Rafael
R
Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General, Hospital Universitario Miguel Servet de Zaragoza, España. jorge_siro@yahoo.es
Cantín-Blázquez
Sonia
S
Bernal-Jaulín
Joaquín
J
Barranco-Domínguez
José Ignacio
JI
Ruiz-Montoya
Jaime
J
Esarte-Muniain
Jesús María
JM
D015746:Abdominal Pain / Q000209:etiology; D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000209:etiology; D003964:Diaphragm / Q000293:injuries*; D050723:Fractures, Bone / Q000150:complications; D006491:Hemothorax / Q000209:etiology; D006549:Hernia, Diaphragmatic, Traumatic / Q000209:etiology / Q000601:surgery; D006801:Humans; D015994:Incidence; D007813:Laparotomy; D008099:Liver / Q000293:injuries; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications; D012189:Retrospective Studies; D012421:Rupture / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D013161:Splenic Rupture / Q000150:complications / Q000601:surgery; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014951:Wounds, Stab / Q000175:diagnosis / Q000601:surgery