Traumatic injuries of the diaphragm

Objectives: In this study, patient characteristics, diagnosisand treatment of patients with traumatic injury of thediaphragm, and the outcomes were evaluated.Materials and methods: Between 2002 and 2012, 19patients were treated for blunt and penetrating diaphragmaticinjury at the Thoracic Surgery Clinics of two teachinghospitals. The patients were evaluated retrospectively.Results: The etiology of trauma was traffic accidents in8 cases, falls from height in three, earthquake-relatedwounds in two, and stab wounds in six cases (SW). Themost frequent complaints and physical findings were dyspnea,chest pain, abdominal distension and the absenceof respiratory sounds. The most frequently encounteredfinding from the chest radiography was disappearance ofdiaphragmatic shadow, elevation of the diaphragm, andvisceral herniation to the thorax. All patients underwentsurgery. A left diaphragmatic rupture was diagnosed in13, and a right diaphragmatic rupture in 6 patients. Fourteenpatients had visceral herniation without strangulation.In fourteen patients, the diaphragmatic injury wasaccompanied by intra-abdominal organ injuries, lung injuriesand the other system injuries. In one case, cardiac injury,and in four cases, an isolated diaphragmatic rupturewas diagnosed. The most commonly associated organ indiaphragmatic injury was the stomach. In all cases, thediaphragm was repaired by two layers of non-absorbablesutures. The mortality was approximately 5.6%, dependingon associated injuries.Conclusion: The prognosis of the blunt and sharp diaphragmaticinjuries depends on the severity of the concomitantinjuries, and on the problems that may arise dueto delays.