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2009, Number 1

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Cir Gen 2009; 31 (1)

Diaphragmatic injuries due to blunt trauma. Experience in a trauma center

Ferrufino MAL, Vázquez MJC, Delgadillo GS

Language: Spanish
References: 21
Page: 26-30
PDF size: 240.56 Kb.


ABSTRACT

Objective: To analyze the prevalence and management of diaphragmatic injuries due to blunt trauma in a trauma-specialized center.
Setting: Third level health care hospital.
Design: Retrospective, observational, descriptive study.
Patients and methods: We reviewed the clinical records of 32 patients with antecedents of thoracoabdominal trauma and diaphragmatic injury, registered in a 7-year period. We analyzed the following variables: gender, age, mechanism and degree of injury, surgical technique used, and morbidity and mortality. All cases were classified according to the diaphragmatic injury scale.
Results: We identified 25 men and 7 women with an average age of 41.5 years (16 to 67 years). The injury mechanism was blunt trauma in all patients. Diagnosis was performed transoperatively. Degree III injuries were the most frequent, involving 23 patients, followed by degree II in four patients, and grades I and IV with three and two patients, respectively. Laparotomy was performed in 29 patients and thoracotomy in three. Two-plane surgical repair with continuous suture was used in all cases. Average hospital stay was of 8.5 days (4 to 13 days). Morbidity was of 18.75%. Mortality was of 6.25%, associated to cranioencephalic trauma.
Conclusions: Traumatic injury of the diaphragm is not a frequent entity. Its diagnosis requires a high degree of clinical suspicion, based on the injury mechanism. Mortality of diaphragmatic lesions is related with the magnitude of the accompanying injuries.


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