[Acute and latent right side diaphragmatic rupture after blunt trauma: cases studies and review of the literature].
A right diaphragmatic rupture (RDR) after blunt trauma is rare. Diagnosis of this entity remains difficult due to the absence of a precise anamnesis and pathognomonic signs. We report two cases of acute and latent RDR respectively. Immediate laparotomy was performed in the first case and thoracotomy was done nine weeks after blunt trauma for the second one. After the hepatothorax reduction, diaphragmatic lesions were sutured and reinforced by prosthesis. Acute RDR evolve inevitably to a latent and obstructive phases. Then, the mainstay treatment is surgical repair of the diaphragmatic defect. At present, thoracotomy is recommended for latent RDR. In the acute phases, thoracic and/or abdominal approaches depend on associated lesions, hemodynamical patient stability and surgical competence of the practitioner.
Service de Chirurgie Digestive, C.H.U. de Charleroi. aouazzan@ulb.ac.be
A
A
Ouazzani
E
E
Guérin
J
J
Dryjski
N
N
Cuylits
J C
JC
Lefebvre
P
P
Vaneukem
D000328:Adult; D000368:Aged; D006549:Hernia, Diaphragmatic, Traumatic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007813:Laparotomy; D008297:Male; D013902:Radiography, Thoracic; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging