Blunt traumatic diaphragmatic rupture
Antônio Carlos Nogueira, Munir Bazzi, Francisco García Soriano, Haydée Jordão, Sueli Vieira Lopes, Sebastião Pontes, Ana Carolina Antunes, João Augusto dos Santos Martinês
Abstract
Antônio Carlos Nogueira, Munir Bazzi, Francisco García Soriano, Haydée Jordão, Sueli Vieira Lopes, Sebastião Pontes, Ana Carolina Antunes, João Augusto dos Santos Martinês
Abstract
Traumatic injury of the diaphragm ranges from 0.6 to 1.2% and rise up to 5% among patients who were victims of blunt trauma and underwent laparotomy. Clinical suspicion associated with radiological assessment contributes to early diagnosis. Isolated diaphragmatic injury has a good prognosis. Generally worse outcomes are associated with other trauma injuries. Bilateral and right diaphragmatic lesions have worse prognosis. Multi detector computed tomography (MDCT) scan of the chest and abdomen provides better diagnostic accuracy using the possibility of image multiplanar reconstruction. Surgical repair via laparotomy and/ or thoracotomy in the acute phase of the injury has a better outcome and avoids chronic complications of diaphragmatic hernia. The authors present the case of a young male patient, victim of blunt abdominal trauma due to motor vehicle accident with rupture of the diaphragm, spleen and kidney injuries. The diagnosis was made by computed tomography of the thorax and abdomen and was confirmed during laparotomy.
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Traumatic injury of the diaphragm ranges from 0.6 to 1.2% and rise up to 5% among patients who were victims of blunt trauma and underwent laparotomy. Clinical suspicion associated with radiological assessment contributes to early diagnosis. Isolated diaphragmatic injury has a good prognosis. Generally worse outcomes are associated with other trauma injuries. Bilateral and right diaphragmatic lesions have worse prognosis. Multi detector computed tomography (MDCT) scan of the chest and abdomen provides better diagnostic accuracy using the possibility of image multiplanar reconstruction. Surgical repair via laparotomy and/ or thoracotomy in the acute phase of the injury has a better outcome and avoids chronic complications of diaphragmatic hernia. The authors present the case of a young male patient, victim of blunt abdominal trauma due to motor vehicle accident with rupture of the diaphragm, spleen and kidney injuries. The diagnosis was made by computed tomography of the thorax and abdomen and was confirmed during laparotomy.
Key concepts: Medicine, Laparotomy, Thoracotomy, Diaphragm (acoustics), Abdomen, Diaphragmatic breathing, Blunt, Thorax (insect anatomy)