Cirujano General

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board

>Journals >Cirujano General >Year 2001, Issue 4

Padilla GMA, Guerrero GVH, Ruiz GGH, Vizcarra DA
Trauma of the diaphragm: Eleven-years experience at the Central Military Hospital
Cir Gen 2001; 23 (4)

Language: Español
References: 17
Page: 229-233
PDF: 4. Kb.

Full text


Objective: To inform on our 11-years experience in the surgical treatment of wounds of the diaphragm.
Setting: Third level health care hospital.
Design: Retrospective, observational study.
Patients and methods: We reviewed the clinical records of 50 patients with thoraco-abdominal trauma, penetrating and blunt, during an 11-years period. We analyzed the following variables: gender, age, diagnosis, mechanisms of lesion, affected hemidiaphragm, associated lesions, morbidity and mortality.
Results: Men predominated (46), average age was of 24 years, only in six patients was the lesion of the diaphragm diagnosed before surgery; in 86% the mechanisms of lesion was due to penetrating trauma and of these 20% were stab wounds and 66% caused by firearms. Injuries to the left side predominated with 64%, associated lesions occurred in 88%, the most frequent one was in the liver in 18 patients, and five cases were documented as isolated lesions. Morbidity was of 34%, only 3 patients (6%) died.
Conclusion: Results agree with those in the literature, it is noteworthy that penetrating trauma was more frequent than the blunt one in the type of analyzed population. The liver was the organ most associated to the lesion. Severity of the associated lesion was a relevant factor influencing morbidity and mortality.

Key words: Thoraco-abdominal trauma, abdomen and thorax injury, diaphragm trauma.


  1. Ward RE, Flynn TC, Clark WP. Diaphragmatic disruption secondary to blunt abdominal trauma. J Trauma 1981; 21: 35-8.

  2. Mansour KA. Trauma to the diaphragm. Chest Surg Clin N Am 1997; 7: 373-83.

  3. Sung CK, Kim KH. Missed injuries in abdominal trauma. J Trauma 1996; 41: 276-82.

  4. Montresor E, Mangiante G, Vassia S, Barbosa A, Attino M, Bortolasi L, et al. La rottura del diaframma da trauma chiuso. Contributo casístico e revisione della litteratura. Ann Ital Chir 1997; 68: 297-303; discussion 303-5.

  5. Spann JC, Nwariaku FE, Wait M. Evaluation of video-assisted thoracoscopic surgery in the diagnosis of diaphragmatic injuries. Am J Surg 1995; 170: 628-30; discussion 630-1.

  6. Ochsner MG, Rozycki GS, Lucente F, Wherry DC, Champion HR. Prospective evaluation of thoracoscopy for diagnosing diaphragmatic injury in thoracoabdominal trauma: A preliminary report. J Trauma 1993; 34: 704-9; discussion 709-10.

  7. Uribe RA, Pachon CE, Frame SB, Enderson BL, Escobar F, Garcia GA. A prospective evaluation of thoracoscopy for the diagnosis of penetrating thoracoabdominal trauma. J Trauma 1994; 37: 650-4.

  8. Asencio JA, Demetriades D, Rodriguez A. Injury to the diaphragm . Trauma. 3 th Ed. Appleton & Lange 1995: 346-82.

  9. Israel RS, McDaniel PA, Primack SL, Salmon CJ, Fountain RL, Koslin DB. Diagnosis of diaphragmatic trauma with helical CT in swine model. Am J Roentgenol 1996; 167: 637-41.

  10. Thomas B, Falcone RE, Vasquez D, Santanello S, Towsend M, Hockenberry S, et al. Ultrasound evaluation of blunt abdominal trauma: program implementation, initial experience, and learning curve. J Trauma 1997; 42: 384-8; discusión 388-90.

  11. Murray JA, Demetriades D, Asencio JA, Cornwell EE 3rd, Velmahos GC, Belzberg H, et al. Occult injuries to the diaphragm: prospective evaluation of laparoscopy in penetrating injuries to the left lower chest. J Am Coll Surg 1998; 187: 626-30.

  12. Neidhardt JP, Caillot JL, Voiglio EJ. Rupture du diafhragme dans les traumatismes fermes. Rev Prat 1997; 47: 971-5.

  13. Murray JG, Caoili E, Gruden JF, Evans SJ, Halvorsen RA Jr, Mackersie RC. Acute rupture of the diaphragm due to blunt trauma: diagnostic sensitivity and specificity of CT. AJR Am J Roentgenol 1996; 166: 1035-9.

  14. Murray JA, Demetriades D, Cornwell EE 3rd, Asencio JA, Velmahos G, Belzberg H, et al. Penetrating left thoracoabdominal trauma: the incidence and clinical presentation of the diaphragm injuries. J Trauma 1997; 43: 624-6.

  15. Letoquart JP, Kunin N, Lechaux D, Gerard O, Morcet N, Mambrini A. Rupture du diaphragme lors des traumatisms fermes: a propos de 28 observations. J Chir (Paris) 1995; 132: 478-82.

  16. Garbuio P, Doury L, Gagneux E, Vichard P. Reflexions sur les ruptures du diaphragme. A propos de 45 cas. Chirurgie 1997; 122: 338-42.

  17. Shah R, Sabanathan S, Means AJ, Choudhury AK. Traumatic rupture of diaphragm. Ann Thorac Surg 1995; 60: 1444-9.

>Journals >Cirujano General >Year 2001, Issue 4

· Journal Index 
· Links 

Copyright 2019