Traumatic rupture of the diaphragm
AbstractBackground and aim: Blunt injury of the chest is the most common form of thoracic trauma. The resulting deceleration injury can cause a life threatening damage to any intra-thoracic structure. We therefore, aimed to highlight the importance of a high index of suspicion while examining patients involved in a road traffic accident or other serious thoracic trauma. Methodology: All the case notes of patients who presented from 1994 to 2004 with blunt injuries to the chest following road traffic accident were reviewed. Those treated for traumatic rupture of the diaphragm were selected and analyzed for age, gender, cause of injury, associated injuries sustained and mode of treatment. They were all treated at the University of Port Harcourt Teaching Hospital and a private clinic in Port Harcourt. Results: 12 patients had traumatic rupture of the diaphragm. All were males and aged between 16 and 46 years (mean 32 years). 10 cases (83.3%) were left sided and 2 (16.7%) were right-sided and there were no bilateral cases. The right-sided cases all died. There were associated injuries in all cases and they involved the spleen, rib fractures, liver and lungs. All the cases were repaired by laparotomy with the exception of the right-sided cases that died from severe haemorrhage. Conclusion: A high index of suspicion combined with repeated and selective radiological evaluation is necessary for early diagnosis and treatment.
Keywords: blunt trauma, diaphragmatic rupture
Sahel Medical Journal Vol. 8(1) 2005: 9-11