ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Penetrating diaphragmatic injuries: a 15-year-experience
Özgür Samancılar1, Cemal Kara2, Kadir Hakan Kayabaş1, Necdet Güler2, Turgay Özer2, Arif Uğuz2, Erdoğan Sü2, Atilla El2
1Karşıyaka Devlet Hastanesi, Göğüs Cerrahisi Kliniği, İzmir
2Karşıyaka Devlet Hastanesi, Genel Cerrahi Kliniği, İzmir
Background: In this study, we reviewed our 15-year-experience in the diagnosis of penetrating diaphragmatic injuries.

Methods: The clinical records of 37 patients (36 males, 1 female; mean age 29.2 years; range 17 to 46 years) who were diagnosed as having penetrating diaphragmatic injury and were operated on in our clinic between January 1994 - December 2008 were evaluated retrospectively.

Results: The majority of the injuries were caused by stabbing (n=31) and the rest by gun-shots. The diagnosis was established in most patients (n=34) during laparotomy. The injury was usually in the left hemidiaphragm (n=24). Twenty-eight patients (75%) had associated injuries and the most common was liver injury (n=14). Only laparotomy was performed in 26 patients, seven of them had laparotomy together with thoracotomy, three had only thoracotomy and one had only laparoscopy. The diaphragmatic defect was repaired primarily in all patients. Morbidity occurred in three cases and mortality also occurred in three cases.

Conclusion: Although there has been great improvement in the diagnostic methods of diaphragmatic injury since it was first defined, a high index of suspicion is still the most important entity that leads to diagnosis. Penetrating injury with a single entry accompanied by thoracoabdominal pathology must be alerting of a diaphragmatic defect. Diaphragm must be explored carefully during the operation for thoracoabdominal penetrating trauma.

Keywords : Diaphragmatic injury; diagnosis/surgery; penetrating trauma
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