Traumatic diaphragmatic rupture:: results of the chest surgery clinic

BACKGROUND Traumatic diaphragmatic rupture is an urgent and life-threatening condition concerning the branches of chest surgery and general surgery because of the accompanying injuries. We reviewed the results of our cases with traumatic diaphragmatic rupture who were operated over a period of 9 years. METHODS The patients who underwent surgery for traumatic diaphragmatic rupture in Department of Chest Surgery Medicine Faculty of Yuzuncu Yil University were included into the study. The diagnosis was established by chest X-ray, computerized thoracic tomography, abdominal ultrasonography, and contrast upper gastrointestinal imaging modalities when needed. RESULTS Twenty-six cases (21 males, 5 females; mean age 33; range 13 to 67 years) with traumatic diaphragmatic rupture were operated in Department of Chest Surgery Medicine Faculty of Yuzuncu Yil University between August 1996 and October 2005. Treatment approach in 15 cases was thoracotomy, in 7 cases laparotomy and in 4 cases thoracotomy + laparotomy, and in all cases, diaphragma was primarily sutured. Left diaphragmatic rupture was detected in 18 cases and right diaphragmatic rupture in 8 cases. Laceration in the diaphragma ranged between 0.5 and 15 cm. Various accompanying injuries were present in all cases except one. Abdominal organs were herniated to the thorax in 12 cases. Three cases who were operated on urgently with severe accompanying injuries died. There was no mortality in the postoperative period and morbidity occurred in 5 cases. CONCLUSION Traumatic diaphragmatic rupture, when overlooked and accompanied with severe injuries, can cause complications and even death. Its diagnosis and treatment must be dealt with rapidly and cautiously.