Early Diagnosis and Treatment of Traumatic Diaphragmatic Injuries


Introduction: Early diagnosis and treatment of injuries of the diaphragm are important both because of high incidence of concomitant injuries and since they may lead to life-threatening intestinal and gastric strangulation in the late term. Herein, cases with diaphragmatic injury that have been diagnosed and operated in the early period after injury or during surgery were presented. Methods: Data of 14 cases, which have been diagnosed with diaphragmatic injury after trauma or during surgical procedure that was performed because of concomitant abdominal or intra-thoracic injury between January 2008 and April 2013, were retrospectively reviewed. Results: Of the traumatic diaphragmatic injuries, 10 (71.4%) have occurred due to penetrating trauma, whereas 4 (28.5%) have occurred due to blunt trauma. Diagnosis was made using I.V. contrast-enhanced whole abdominal and thoracic tomography in all 3 pediatric cases (21.4%) and during surgery in the others (78.5%). Conclusion: All of the diaphragmatic injuries have been accompanied by intra-abdominal or intra-thoracic organ injury that requires surgery. In these cases, the diagnosis was made on suspicion of diaphragmatic injury in the course of surgical procedure performed for concomitant organ injury. Computed tomography was diagnostic for diaphragmatic injuries in the pediatric cases.

Share and Cite:

F. Kurt, M. Abeş, E. Dadaş, B. Petik and M. Şirik, "Early Diagnosis and Treatment of Traumatic Diaphragmatic Injuries," Surgical Science, Vol. 5 No. 2, 2014, pp. 57-59. doi: 10.4236/ss.2014.52013.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] I. Karnak, M. E. Senocak, F. C. Tanyel and N. Büyükpamukcu, “Diaphragmatic Injuries in Childhood,” Surgery Today, Vol. 31, No. 1, 2001, pp. 5-11. http://dx.doi.org/10.1007/s005950170212
[2] B. S. Powell, L. J. Magnotti, T. J. Schroeppel and C. W. Finnell, “Diagnostic Laparoscopy for the Evaluation of Occult Diaphragmatic Injury Following Penetrating Thoracoabdominal Trauma Injury,” Injury—International Journal of Care of Injured, Vol. 39, No. 5, 2008, pp. 530-534.
[3] W. C. Hanna and L. E. Ferri, “Acute Traumatic Diaphragmatic Injury,” Thoracic Surgery Clinics, Vol. 19, No. 4, 2009, pp. 485-489. http://dx.doi.org/10.1016/j.thorsurg.2009.07.008
[4] S. Sozübir, B. Tander, F. Bernay, E. Aritürk, R. Rizalar and N. Gürses, “Traumatic Diaphragmatic Ruptures in Children,” Ulusal Travma Dergisi, Vol. 11, No. 1, 2005, pp. 64-68.
[5] U. K. Bodanapally, K. Shanmuganathan, S. E. Mirvis, C. W. Sliker, T. R. Fleiter, K. Sarada, L. A. Miller, D. M. Stein and M. Alexander, “MDCT Diagnosis of Penetrating Diaphragm Injury,” European Radiology, Vol. 19, No. 8, 2009, pp. 1875-1881. http://dx.doi.org/10.1007/s00330-009-1367-9
[6] D. M. Stein, G. B. York, S. Boswell, K. Shanmuganathan, J. M. Haan and T. M. Scalea, “Accuracy of Computed Tomography (CT) Scan in the Detection of Penetrating Diaphragm Injury,” Journal of Trauma, Vol. 63, No. 3, 2007, pp. 538-543. http://dx.doi.org/10.1097/TA.0b013e318068b53c
[7] C. T. Ramos, B. Z. Koplewitz, P. S. Babyn, P. S. Manson and S. H. Ein, “What Have We Learned about Traumatic Diaphragmatic Hernias in Children?” Journal of Pediatric Surgery, Vol. 35, No. 4, 2000, pp. 601-604. http://dx.doi.org/10.1053/jpsu.2000.0350601
[8] K. Turhan, O. Makay, A. Cakan, O. Samancilar, O. Firat, G. Icoz and U. Cagirici, “Traumatic Diaphragmatic Rupture: Look to See,” European Journal of Cardio-Thoracic Surgery, Vol. 33, No. 6, 2008, pp. 1082-1085. http://dx.doi.org/10.1016/j.ejcts.2008.01.029
[9] J. A. Perlingeiro, R. Saad Jr., C. L. Lancelotti, S. Rasslam, P. C. Candelária and S. C. Soldá, “Natural Course of Penetrating Diaphragmatic Injury: An Experimental Study in Rats,” International Surgery, Vol. 92, No. 1, 2007, pp. 1-9.
[10] W. C. Hanna, L. E. Ferri, P. Fata, T. Razek and D. S. Mulder, “The Current Status of Traumatic Diaphragmatic Injury: Lessons Learned from 105 Patients over 13 Years,” The Annals of Thoracic Surgery, Vol. 85, No. 3, 2008, pp.1044-1048. http://dx.doi.org/10.1016/j.athoracsur.2007.10.084
[11] A. H. Al-Salem, “Traumatic Diaphragmatic Hernia in Children,” Pediatric Surgery International, Vol. 28, No. 7, 2012, pp. 687-691. http://dx.doi.org/10.1007/s00383-012-3107-5

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.