An unusual diaphragmatic injury: A case report
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Case Reports
VOLUME: 24 ISSUE: 1
P: 42 - 45
March 2008

An unusual diaphragmatic injury: A case report

Turk J Surg 2008;24(1):42-45
1. Ankara Numune Eğitim ve Araştırma Hastanesi 2. Cerrahi Kliniği, ANKARA
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Abstract

The diaphragmatic injury is often associated with thoracoabdominal traumas and it is often located at the left diaphragm. A 23 years old man who had sharp penetrating trauma was admitted to emergency department. In his physical examination a 1.5 cm incision was seen on the left upper anterior chest. There was no associating pneumothorax, hemithorax or abdominal trauma. Unexpectedly, one day after the incident, a knife was recognized at left upper quadrant at a control chest X-ray. Laparotomy was performed and the knife was found located among left lobe of liver, spleen, stomach and colon. There was no injury at these organs. The diaphragm was repaired and patient was transferred to psychiatry clinic on the second post-operative day. Penetrating thoracoabdominal traumas can be concomitant with abdominal injuries, so the patient must be examined systematically and carefully.

Keywords:
Thoracoabdominal trauma, diaphragmatic injury

References

1
Meyers BF, McCabe CJ. Traumatic diaphragmatic hernia. Occult marker of serious injury. Ann Surg 1993; 218:783-790.
2
Leppäniemi A, Haapiainen R. Occult diaphragmatic injuries caused by stab wounds. J Trauma 2003; 55:646-650.
3
Murray JA, Demetriades D, Asensio JA,et al. Occult injuries to the diaphragm: prospective evaluation of laparoscopy in penetrating injuries to the left lower chest. J Am Coll Surg. 1998; 187:626-630.
4
Asensio JA, Demetriodes D, Rodrigez A. Injury to the diaphragm. Trauma, third edition, Appleton & Lange 1996; 461-485.
5
Komar AR, Dunn E. Penetrating abdominal trauma. Med J; 2001:1-15.
6
Miller L, Bennett RV Jr, Rout HD et al. Management of penetrating and blunt diaphragmatic injury. J Trauma 1984; 24:403-409.
7
Waldschmidt ML, Vacus HL. Injurİes of the diapragm. J Trauma 1980; 20:587-592.
8
Feliciano DV, Cruse PA, Mattox KL et al. Delayed diagnosis of injuries to the diapragm after penetrating injury. J Trauma 1988; 28:1135-1144.
9
Madden MR, Dowl DE, Finkelstein JL. Occult diaphragmatic injury from stab wounds to the lower chest and abdomen. J Trauma 1989; 29:292-298.
10
Feliciano DV, Cruse PA, Mattox KL. J Trauma 1988; 8:1135-1144.
11
Panagiotis NS. Diaphragmatic injuries. In: Shields TW, ed. General Thoracic Surgery. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2005: 1006-1014.
12
Aronoff RJ, Reynolds J, Thal E. Evaluation of diaphragmatic injuries. Am J Surg 1982; 144: 671-675.
13
Johnson CD. Blunt injuries of the diaphragm. Br J Surg 1988; 75: 226-230.
14
Morgan AS, Flancbaum L, Esposito T, et al. Blunt injury of the diaphragm: an analysis of 44 patients. J Trauma 1986; 26:565-568.
15
Sutton JP, Carlisle RB, Stephenson SE Jr. Traumatic diaphragmatic hernia. A review of 25 cases. Ann Thorac Surg 1967; 3:136-50.
16
Özısık K, Ertürk M, Köse S, Kerimoğlu B, Peker Ro. Atesli silahlarla olusan diyaframa yaralanmalarında torakoabdominal insizyonun yeri. Turkiye Klinikleri J Cardiovascular Surgery 2001; 2:11-14.
17
Shanmuganathan K, Mirvis SE. Imaging diagnosis of nonaortic thoracic injury. Radiol Clin North Am1999; 37:533-551.
18
Voeller GR, Reisser JR, Fabian TC, et al. Blunt diaphragm injuries: a five years experience Am J Surg 1990; 56:28-32.
19
McQuay N Jr, Britt LD. Laparoscopy in the evaluation of penetrating thoracoabdominal trauma. Am Surg 2003; 69:788-791.
20
Ortega AE, Tang E, Froes ET,et al. Laparoscopic evaluation of penetrating thoracoabdominal traumatic injuries. Surg Endosc 1996; 10:19-22.
21
Ali J, Qi W The effects of positive airway pressure and intra-abdominal pressure in diaphragmatic rupture. World J Surg 1992; 16:1120-1124.
22
Shatney CH, Sensaki K, Morgan L. The natural history of stab wounds of the diaphragm: implications for a new management scheme for patients with penetrating thoracoabdominal trauma. Am Surg 2003; 69:508-513.
23
Drews JA, Mercer EC, Benfield Jr. Acute diaphragmatic injuries. Ann Thorac Surg 1973; 16:67,
24
Hood RM. Traumatİc Diaphragmatic hernia. Ann Thorac Surg 1971; 12:311,
25
Hood RM. ınjurİes involving the diaphragm. In Hood RM, Boyd AD, Cullİford AT (eds): Thoracic Trauma. Philedelphia, WB Saunders, 1989; 267-289.