Importance of diagnostic laparoscopy in the assessment of the diaphragm after left thoracoabdominal stab wound: A prospective cohort study
| Autor: | Metin Yücel, Orhan Alimoglu, Gürhan Baş, Fatih Başak, Hüseyin Kerem Tolan, Ethem Unal, Adnan Özpek |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Thoracic Injuries medicine.medical_treatment Diaphragm Diaphragmatic breathing Peritonitis Abdominal Injuries Wounds Stab 03 medical and health sciences Young Adult 0302 clinical medicine Laparotomy Medicine Humans 030212 general & internal medicine Prospective Studies Stab wound Laparoscopy Prospective cohort study Hemopneumothorax Evisceration (ophthalmology) medicine.diagnostic_test business.industry 030208 emergency & critical care medicine Middle Aged medicine.disease Surgery Anesthesiology and Pain Medicine Emergency Medicine Female business |
| Zdroj: | Ulusal travma ve acil cerrahi dergisi = Turkish journal of traumaemergency surgery : TJTES. 23(2) |
| ISSN: | 1306-696X |
| Popis: | BACKGROUND Stab wounds in the left thoracoabdominal region may cause diaphragmatic injury. The aim of the present study was to determine incidence of diaphragmatic injury and role of diagnostic laparoscopy in detection of injury in patients with left thoracoabdominal stab wound. METHODS Total of 81 patients (75 male, 6 female; mean age 27.5±9.8 years; range 14 to 60 years) who presented with left thoracoabdominal stab wound between April 2009 and September 2014 were evaluated. Laparotomy was performed on patients who had hemodynamic instability, signs of peritonitis, or organ evisceration. Remaining patients were followed conservatively. After 48 hours, diagnostic laparoscopy was performed on patients without laparotomy indication to examine the left diaphragm for injury. Follow-up and treatment findings were prospectively evaluated. RESULTS Thirteen patients underwent laparotomy while diagnostic laparoscopy was performed on remaining 68 patients. Left diaphragmatic injury was observed in 19 patients (23.5%) in the study group. Four injuries were diagnosed by laparotomy and 15 were diagnosed by laparoscopy. Presence of hemopneumothorax did not yield difference in incidence of diaphragmatic injury (p=0.131). No significant difference was detected in terms of diaphragmatic injury with respect to entry site of stab wound in the thoracoabdominal region (p=0.929). CONCLUSION It is important to evaluate the diaphragm in left thoracoabdominal stab injuries, and diagnostic laparoscopy is still the safest and most feasible method. |
| Databáze: | OpenAIRE |
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