Diaphragmatic injuries

Challenges in the diagnosis and management

Patrizio Petrone, Ari Leppäniemi, Kenji Inaba, Kjetil Søreide, Juan A. Asensio

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Establishing the clinical diagnosis of diaphragmatic injuries (DI) can be challenging for the trauma surgeon, as it is often clinically occult. Accurate diagnosis is critical however as a missed DI may result in grave sequelae due to herniation and strangulation of displaced intra-abdominal organs. The etiology of DI includes the following mechanisms: blunt, penetrating, and iatrogenic. Vital information about the mechanism of injury should be obtained from the emergency medical personnel. Left-sided hemidiaphragmatic injuries are considerably more common than right-sided injuries. Patients with right-sided hemidiaphragm rupture have higher pre-hospital mortality resulting from the greater impacting force require to produce a right-sided DI, associated with significant vascular injury. The diagnosis of a DI by imaging studies presents a challenge, as evidenced by the large number of investigative procedures employed to establish the diagnosis. Minimally invasive technology in the form of laparoscopy and thoracoscopy is in the trauma surgeon's diagnostic and therapeutic armamentarium. The surgical care of DI can be classified according to the phase of clinical presentation, into injuries requiring management in their acute phase versus those in their chronic phase. The patient's survival depends on the severity of their associated injuries, but if DI is not diagnosed promptly a missed injury can be associated with a high morbidity and mortality.

Original languageEnglish
Pages (from-to)227-236
Number of pages10
JournalTrauma
Volume9
Issue number4
DOIs
StatePublished - Oct 2007
Externally publishedYes

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Wounds and Injuries
Thoracoscopy
Vascular System Injuries
Patient Rights
Hospital Mortality
Laparoscopy
Rupture
Emergencies
Technology
Morbidity
Survival
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Diaphragmatic injuries : Challenges in the diagnosis and management. / Petrone, Patrizio; Leppäniemi, Ari; Inaba, Kenji; Søreide, Kjetil; Asensio, Juan A.

In: Trauma, Vol. 9, No. 4, 10.2007, p. 227-236.

Research output: Contribution to journalArticle

Petrone, P, Leppäniemi, A, Inaba, K, Søreide, K & Asensio, JA 2007, 'Diaphragmatic injuries: Challenges in the diagnosis and management', Trauma, vol. 9, no. 4, pp. 227-236. https://doi.org/10.1177/1460408607087716
Petrone, Patrizio ; Leppäniemi, Ari ; Inaba, Kenji ; Søreide, Kjetil ; Asensio, Juan A. / Diaphragmatic injuries : Challenges in the diagnosis and management. In: Trauma. 2007 ; Vol. 9, No. 4. pp. 227-236.
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