[Diagnosis that should be remembered during evaluation of trauma patients: diaphragmatic rupture].
BACKGROUND
We aimed to emphasize the importance of delay in diagnosis of traumatic diaphragmatic ruptures and to investigate the results of treatment methods.


METHODS
The records of 13 patients (11 males, 2 females; mean age 34.6; range 7 to 52 years) with traumatic diaphragmatic ruptures were evaluated with respect to demographic data, type and time of trauma, symptoms, diagnostic methods, localization, surgical therapy, morbidity and mortality.


RESULTS
Blunt trauma was present in 8 cases (61.6%) and penetrating trauma in 5. Migration of abdominal organs into hemithorax was detected in 11 cases radiologically. The duration between diagnosis and the event was 2-20 years in 6 patients (46.1%). Three of them were penetrating and 3 were blunt trauma. In 3 cases, diagnosis had been overlooked despite exploratory thoracotomy and laparotomy in another center. Right hemi-diaphragm was injured in 1 patient and the left in 12 cases. Primary repair through posterolateral thoracotomy was performed in all cases. Morbidity occurred in 1 patient. No mortality was observed.


CONCLUSIONS
Diaphragmatic ruptures should be remembered in trauma cases because of the probability of their being missed, and ruptures should be explored during thoracotomy or laparotomy performed for other organ injuries. Delayed diagnosis will increase morbidity and mortality.
Sanli
Maruf
M
Department of Thoracic Surgery, Gaziantep University Faculty of Medicine, Gaziantep, Turkey. sanli@gantep.edu.tr
Işik
Ahmet Feridun
AF
Tunçözgür
Bülent
B
Meteroğlu
Fatih
F
Elbeyli
Levent
L
D000293:Adolescent; D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D003964:Diaphragm / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007813:Laparotomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D011859:Radiography; D012421:Rupture / Q000175:diagnosis; D013903:Thoracic Surgery / Q000379:methods; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D014950:Wounds, Penetrating / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult