Autopsy and Case Reports (Sep 2011)

Blunt traumatic diaphragmatic rupture

  • Antonio Carlos Nogueira,
  • Munir Bazzi,
  • Francisco Garcia Soriano,
  • Haydée Jordão,
  • Sueli Vieira Lopes,
  • Sebastião Pontes,
  • Ana Carolina Makino Antunes,
  • João Augusto dos Santos Martines

DOI
https://doi.org/10.4322/acr.%y.26066
Journal volume & issue
Vol. 1, no. 3

Abstract

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Traumatic injury of the diaphragm ranges from 0.6 to 1.2% and rise up to 5% among patients who were victims of blunt trauma and underwent laparotomy. Clinical suspicion associated with radiological assessment contributes to early diagnosis. Isolated diaphragmatic injury has a good prognosis. Generally worse outcomes are associated with other trauma injuries. Bilateral and right diaphragmatic lesions have worse prognosis. Multi detector computed tomography (MDCT) scan of the chest and abdomen provides better diagnostic accuracy using the possibility of image multiplanar reconstruction. Surgical repair via laparotomy and/ or thoracotomy in the acute phase of the injury has a better outcome and avoids chronic complications of diaphragmatic hernia. The authors present the case of a young male patient, victim of blunt abdominal trauma due to motor vehicle accident with rupture of the diaphragm, spleen and kidney injuries. The diagnosis was made by computed tomography of the thorax and abdomen and was confirmed during laparotomy.

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