Abstract:

Objectives: In this study, patient characteristics, diagnosis and treatment of patients with traumatic injury of the diaphragm, and the outcomes were evaluated. Materials and methods: Between 2002 and 2012, 19 patients were treated for blunt and penetrating diaphragmatic injury at the Thoracic Surgery Clinics of two teaching hospitals. The patients were evaluated retrospectively. Results: The etiology of trauma was traffic accidents in 8 cases, falls from height in three, earthquake-related wounds in two, and stab wounds in six cases (SW). The most frequent complaints and physical findings were dyspnea, chest pain, abdominal distension and the absence of respiratory sounds. The most frequently encountered finding from the chest radiography was disappearance of diaphragmatic shadow, elevation of the diaphragm, and visceral herniation to the thorax. All patients underwent surgery. A left diaphragmatic rupture was diagnosed in 13, and a right diaphragmatic rupture in 6 patients. Fourteen patients had visceral herniation without strangulation. In fourteen patients, the diaphragmatic injury was accompanied by intra-abdominal organ injuries, lung injuries and the other system injuries. In one case, cardiac injury, and in four cases, an isolated diaphragmatic rupture was diagnosed. The most commonly associated organ in diaphragmatic injury was the stomach. In all cases, the diaphragm was repaired by two layers of non-absorbable sutures. The mortality was approximately 5.6%, depending on associated injuries. Conclusion: The prognosis of the blunt and sharp diaphragmatic injuries depends on the severity of the concomitant injuries, and on the problems that may arise due to delays.

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