Outcome of Blunt Diaphragmatic Rupture. Analysis of 44 Cases

To determine the predictors of outcome after blunt diaphragmatic rupture, the records of 44 patients aged 15–70 years (84.1% male) who underwent diaphragm repair between 1998 and 2007 were reviewed. There were 38 (86.4%) cases of acute diaphragmatic rupture and 6 (13.6%) of post-traumatic diaphragma...

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Bibliographic Details
Published in:Asian cardiovascular & thoracic annals 2010-06, Vol.18 (3), p.240-243
Main Author: Gwely, Noureldin Noaman
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Aged
Chi-Square Distribution
Diaphragm - injuries
Diaphragm - surgery
Egypt
Female
Hernia, Diaphragmatic, Traumatic - diagnosis
Hernia, Diaphragmatic, Traumatic - mortality
Hernia, Diaphragmatic, Traumatic - surgery
Humans
Laparotomy - adverse effects
Laparotomy - mortality
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Rupture
Severity of Illness Index
Thoracic Injuries - diagnosis
Thoracic Injuries - mortality
Thoracic Injuries - surgery
Thoracotomy - adverse effects
Thoracotomy - mortality
Treatment Outcome
Wounds, Nonpenetrating - diagnosis
Wounds, Nonpenetrating - mortality
Wounds, Nonpenetrating - surgery
Young Adult
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Summary:To determine the predictors of outcome after blunt diaphragmatic rupture, the records of 44 patients aged 15–70 years (84.1% male) who underwent diaphragm repair between 1998 and 2007 were reviewed. There were 38 (86.4%) cases of acute diaphragmatic rupture and 6 (13.6%) of post-traumatic diaphragmatic hernia. The injury was left-sided in 30 (68.2%) patients, right-sided in 12 (27.3%), and bilateral in 2 (4.5%). The diagnosis of acute diaphragmatic rupture was made preoperatively in 28 (73.7%) patients and intraoperatively in 10 (26.3%). Repair was carried out through a thoracotomy in 31 cases, laparotomy in 4, and thoracolaparotomy in 3. The mortality rate after diaphragmatic rupture was 13.2% (5/38). The 33 survivors had a significantly younger mean age (37 vs. 57 years) and lower incidences of multiple injuries (36.4% vs. 100%) and shock (24.2% vs. 100%). Repair of diaphragmatic hernia was performed through a thoracotomy in all cases, with no mortality. It was concluded that age, associated severe multiple injuries, and clinical status were predictors of mortality after blunt diaphragmatic rupture.
ISSN:0218-4923
1816-5370
DOI:10.1177/0218492310368740