Diagnosis and treatment of thoracoabdominal combined injuries in 82 cases

Objective:To study the clinical features and treatment experience in the treatment of thoracoabdominal combined injury (TCI) with diaphragmatic rupture.Methods:A retrospective study was carried out in 82 cases of TCI treated surgi cally.Among them,there were 36 cases (36.90%) with penetrating injury caused by sharp instrument and 46(63.10%) with blunt injury.Traffic injury was commonly seen.The injuries due to different causes and with diaphragmatic rup ture were analysed retrospectively.Results:This kind of injuries was usually complicated by multiple organ injuries.Of 82 cases,38 (46.34%) had diaphragmatic ruptures preoperatively,78 (95.12%) diaphragmatic rupture was found in the first operation and was repaired;4 (4.88%) were missed diagnosis of diaphragmatic injuries and 11 (13.41%) died.Conclusion:TCI is a special type of multiple trauma with severe and complicated injuries and a high mortality.The diagnosis should be based on the mechanism of trauma and volume of bleeding.In the meantime,special attention should be paid to avoid the missed diagnosis of diaphragmatic injuries.The treatment principle is early diagnosis and timely operation,thoracic injury first and laparotomy second.