Injuries of the Diaphragm
Authors:
Lukáš Nechvátal 1; Jaromír Kočí 1,2,3; Karel Šmejkal 1,3; Jan Trlica 1; Tomáš Holeček 1; Eva Kočová 4; Tomáš Dědek 1
Authors place of work:
Chirurgická klinika FN a LF UK Hradec Králové
Department of Surgery, University Hospital and Medical Faculty of the Charles University of Hradec Kralove, Czech Republic
1; Oddělení urgentní medicíny FN Hradec Králové
Department of Emergency Medicine, University Hospital of Hradec Kralove, Czech Republic
2; Katedra vojenské chirurgie FVZ UO Brno
Department of Military Surgery, FVZ UO Brno, Czech Republic
3; Radiologická klinika FN a LF UK Hradec Králové
Department of Radiology, University Hospital and Medical Faculty of the Charles University of Hradec Kralove, Czech Republic
4
Published in the journal:
Úraz chir. 24., 2016, č.3
Summary
Introduction:
Rupture of the diaphragm is an uncommon injury, seen in patients with multiple injury or polytrauma. The aim of our study was to evaluate the incidence of this type of injury and it´s influence on morbidity and mortality.
Material and methods:
All patients from the University Hospital of Hradec Králové Traumacentre’s database brought by ambulance and in whom a rupture diaphragm was diagnosed in a six-year period (1. 1. 2008 – 31. 12. 2013), were included in this study.
Results:
In the above mentioned period 3309 patients were brought by ambulance to the University Hospital of Hradec Králové and in 18 of them was rupture of the diaphragm diagnosed. Blunt injury was clearly the leading trauma mechanism (n=14), the patients were most commonly stuck in a vehicle (n=9). 6 patients died in total (33 %).
Conclusions:
Diagnostics of diaphragm rupture is because of it´s low incidence, still very challenging. Despite of a negative primary CT-exam later manifestation cannot be excluded. Therefore it is inevitable, in case of sudden dyspnea or collapse and adequate trauma history to bear in mind the option of this rare injury.
Key words:
Diaphragm rupture, polytrauma.
Zdroje
1. American College of Surgeons Committee on Trauma. Advanced Trauma Life Support for Doctors. 9th ed. Chicago, IL: American College of Surgeons Committee. 2012, 16.
2. BEESON, A., POPOVICI, Z. Diaphragmatic injuries. Invited comment in Thoracic Surgery: Surgical management of Chest Injuries. In: Webb WR, Beeson A, eds. St. Luis Mosby-Year Book, 1991, 317–322.
3. DVOŘÁK, P., HOFFMAN, P., LOCHMAN, P. Opožděná manifestace traumatické ruptury bránice – kazuistika. Anes Intenz Med. 2014, 25, 373–377.
4. GRIMES, O. Traumatic injuries to the diaphragm. Am J Surg. 1974, 128, 175–181.
5. HANNA, WC., FERRI, LE., FATA, P. et al. The current status of traumatic diaphragmatic injury: lessons learned from 105 patients over 13 years. Ann Thorac Surg. 2008, 85, 1044–1048.
6. National Trauma Data Bank, American College of Surgeons, years 2002 through 2007.
7. SHAH, R., SABANATHAN, S., MEARNS, AJ. et al. Traumatic rupture of diaphragm. Ann Thor Surg. 1995, 60, 1444–1449.
8. SYMBAS, PN., VLASIS, SE,, HATCHER, C. Jr. Blunt and penetrating diaphragmatic injuries with or without herniation of organs into the chest. Ann Thorac Surg. 1986, 42, 158–162.
9. ŠIMÁNEK, V., TŘEŠKA, V., KLEČKA, J. et al. Pozdně diagnostikovaná ruptura bránice – kazuistika. Rozhl Chir. 2009, 88, 262–263.
10. Van LOENHOUT, RM., SCHIPHURST, TJ., WITTENS, CH. et al. Traumatic intrapericardial diaphragmatic hernia. J Trauma. 1986, 26, 271–275.
11. VYHNÁNEK, F., FANTA, J., VACH, B. et al. Traumatická ruptura bránice u tupého poranění. Rozhl Chir. 2002, 81, 203–235.
Štítky
Surgery Traumatology Trauma surgeryČlánok vyšiel v časopise
Trauma Surgery
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