FEATURES OF DIAGNOSTICS AND SURGICAL STRATEGY OF DIAPHRAGMATIC RUPTURE IN PATIENTS WITH CLOSED CHEST AND ABDOMINAL POLYTRAUMA

Abstract

The article presents results of diagnostics and surgical treatment of diaphragmatic rupture in 32 victims with an estimation of diagnostic value of different instrumental methods of investigation and the efficacy of surgical approach. The correct interpretation of typical clinical and instrumental signs in consideration with trauma mechanogenesis allowed diagnostics of diaphragmatic rupture before the operation in 17 (53,1%) cases. It was observed that an undiagnosed rupture of the left hemidiaphragm caused a formation of posttraumatic diaphragmatic hernia in 2 (6,2%) patients. The laparotomy was applied in 28 patients as a surgical approach and thoracotomy - in 2patients. The laparotomy and after that thoracotomy were performed on one patient. The thoracotomy and laparotomy were carried out on the second patient in turn. The authors consider the laparotomy as optimal variant of surgical approach in acute period of trauma. The postoperative lethality was 15,6%.

Keywords

• closed chest and abdominal polytrauma
• rupture of the diaphragm
• diagnostics
• surgical treatment
• закрытая сочетанная травма груди и живота
• разрыв диафрагмы
• диагностика
• хирургическое лечение