Management of delayed presentation of a right-side traumatic diaphragmatic rupture
| Autor: | Erhan Reis, Ali Guner, Yildiray Bekar, Umit Kaya, Omer Faruk Ozkan, Can Kece |
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| Rok vydání: | 2011 |
| Předmět: |
Thorax
Adult Male medicine.medical_specialty Delayed Diagnosis medicine.medical_treatment Diaphragmatic breathing Postoperative Complications Laparotomy Medicine Humans Diaphragmatic hernia Hernia Thoracotomy Herniorrhaphy Aged Diaphragmatic rupture business.industry Length of Stay Middle Aged medicine.disease Hernia Diaphragmatic Traumatic Surgery Treatment Outcome Blunt trauma Female business Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | World journal of surgery. 36(2) |
| ISSN: | 1432-2323 |
| Popis: | Right-side diaphragmatic rupture is an unusual condition after blunt trauma. The diagnosis may be missed during the early period of trauma and may lead to progressive herniation of intraabdominal contents into the thorax. In this study, we aimed to evaluate the diagnosis and treatment options for the late diagnosis of cases of right-side traumatic diaphragmatic rupture. We evaluated the patients with diaphragmatic hernia who were admitted to the hospital during an 8-year period. Only patients with a right-side diaphragmatic hernia and a history of high-energy trauma were included in the study. Patients with left-side diaphragmatic hernia or those who were subjected to emergency operation due to diaphragmatic rupture were excluded from the study. Patient characteristics, clinical presentations, diagnostic tools, and treatment options were evaluated. Eight patients (five men, three women) were enrolled in the study. The most common trauma type was a traffic accident, and the average interval between the trauma and diagnosis was 10 years. Thoracoabdominal computed tomography had high sensitivity and specificity for visualizing the diaphragmatic hernia. No predisposing factor was found to add laparotomy to thoracotomy. There was no postoperative mortality, and no late complications were observed at the assessments during the 45-month follow-up. Clinical presentation of late diagnosed diaphragmatic hernia, which is encountered only rarely on the right side, requires diagnostic and therapeutic approaches different from those associated with acute diaphragmatic rupture. It should not be forgotten during the differential diagnosis in patients with a history of trauma. |
| Databáze: | OpenAIRE |
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