The problems in manifestation,diagnosis and treatment of traumatic diaphragmatic rupture
LIU Gao-feng
LI Bao-tian
CUI Su-juan
LI Dan-dan
LIU Yan
ZANG Yong-jie
ZHANG Yong
LI Dong-fang
Abstract：Objective To investigate the problems in manifestation,diagnosis and treatment of traumatic diaphragmatic rupture(TDR).Methods The clinical data of 54 TDR patients from Jan.1980 to Jan.2015 were retrospectively analyzed.There were 43 males and 11 females,with an average age of 36 ±16.2(range,7-68 year old).There were 48 cases of left phragmatic rupture and 6 cases of right phragmatic rupture.The rate of open and closed diaphragmatic rupture were 10.0%(1 /10)and 90.9%(40/44),respectively(P <0.01).Results Thirty-one patients were not diagnosed within 24 hours following admission(57.4%).The rate of misdiagnosis and de-layed diagnosis were 14.8%(8 /54) and 42.6%(23/54),respectively(P <0.01).The diagnosed rate of X ray, CT,and ultrasonic examination were 51.4%(19 /37),87.5%(28/32) and 56.3%(9 /16),respectively.Twenty-three cases were diagnosed by 2 or 3 examinations.There were signification differences between CT examination and X ray examination or ultrasonic examination (P <0.05).Forty-one diaphragmatic hernia cases were found hard to return during operations and 29.3% of them adhered with thoracic cavity.Nine cases were treated by surgery be-cause of necrosis or strangulation.In this study,51 cases were cured(94.4%),3 cases died because of traumatic shock,severe head injury,and multiple organ dysfunction failure with an average injury severity score(ISS)of 42.4 points. Conclusion The main diagnosis basis of TDR is double cavities after trauma and imaging examination. Early diagnosis,reasonable choices of surgical methods and active management of associated injuries are main con-cerns in clinical application.
Keywords：diaphragm rupturediagnosissurgical treatment
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 6-9 )