[Diaphragmatic traumas. Personal experience].
OBJECTIVE
Diaphraghmatic injuries are rare (5-7%), usually secondary to blunt, or more rarely penetrating, thoracic or abdominal trauma. The most frequent site of trauma is the left postero-lateral region. We'll try to review this pathology in all its aspects.


METHODS
We report our personal experience from January 2002 to December 2004 on 280 thoraco-abdominal trauma, 262 (93.5%) blunt and 18 (6.5%) penetrating, of which 5 (3.7%) interested the diaphragm. 4 following a blunt trauma and 1 an open trauma (gunshot) Each trauma was evaluated for possible associated injuries and for the type of symptoms at the admission and during the hospitalization. Preoperative diagnosis has been obtained only in 3 patients, haemodynamically stable. In the other 2 cases an emergency laparotomy was carried out because of their critic conditions and the diaphragmatic injuries were recognized during the procedure. Two patients died.


CONCLUSIONS
We remark as during the acute phase the diaphragmatic rupture may be missed because of shock, respiratory insufficiency or coma of the patient; however, it's mandatory that the right diagnosis is reached as soon as possible in order that mortality is mostly influenced by the time elapsing between trauma and diagnosis.
Buffone
Antonino
A
Università degli Studi di Catania, Dipartimento di Chirurgia, Sezione di Chirurgia d'Urgenza, Catania. a.buffone@unict.it
Basile
Guido
G
Leanza
Silvana
S
Scirè
Francesco
F
Bonaccorso
Antoinette Marie
AM
Cirino
Ercole
E
D000007:Abdominal Injuries / Q000453:epidemiology / Q000601:surgery; D000328:Adult; D003964:Diaphragm / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D012421:Rupture / Q000453:epidemiology / Q000601:surgery; D013898:Thoracic Injuries / Q000453:epidemiology / Q000601:surgery; D014950:Wounds, Penetrating / Q000453:epidemiology / Q000601:surgery