Traumatic diaphragmatic rupture: a common missed diagnosis Print

Traumatic diaphragmatic rupture (TDR) is a life-threatening condition that is quite uncommon and often results from either blunt or penetrating trauma. This entity may be diagnosed late. The purpose of study was to review experiences about diaphragmatic rupture and diagnostic defects that would be helpful in rapid diagnosis and treatment of these patients. A retrospective case note analysis was performed on the five patients treated for TDR between October 1997 and October 2011. Five patients (4 men and 1 woman) between 13 and 63years of age (mean age 37) were included in the study. Total five cases had diaphragmatic rupture in left side. One patient had penetrating injuries and 4 patients had blunt injuries. The diagnosis was done preoperatively in 3 cases and postoperatively in 2 cases. As a consequence in 2cases TDR had not been diagnosed even by intraoperative exploration in others centers. In four cases، the diagnosis was delayed from three days to four years. TDR is a relative uncommon event and represents a diagnostic challenge and It also may be missed during operation. A high index of suspicion combined with repeated and selective radiologic evaluation، thorough examination of abdomen and both the hemi diaphragms during emergency laparotomy can help surgeons in accurate diagnosis.