Diagnosis and treatment of injury of the diaphragm

AIM To study some characteristics in diagnosis and treatment of injury of the diaphragm. METHODS Summarized the diagnosis and treatment of 5 cases of injury of the diaphragm. Of the 5 cases, 2 resulted from penetrating injuries and 3 due to closed injuries. All patients had other associated injuries. 2 patients operated with thoracotomy and 3 with laparotomy, including 2 with subsequent abdominothoracic incisions. RESULTS The diagnosis was established preoperatively in one case(20%). No patient died. CONCLUSION Injury of the diaphragm has mainly four symptoms: chest pain, chest tightness, panting and abdominal pain. CT can reveal indirect characteristics of injury of the diaphragm, such as: lung contusion, hemothorax, hemopneumothorax and hydrops around liver or spleen. Operation is the main method for making a diagnosis of injury of the diapharagm.The key in reducing misdiagnosis is careful inspection of the diaphragm at operation. It is suitable for treating thoracoabdominal penetrating injury with thoracotomy and thoracoadbominal closed injury with laparotomy.