scholarly journals Diaphragmatic Rupture With Left Colon and Spleen Herniation and Small Intestine Injury After Blunt Trauma

2021 ◽  
Author(s):  
Jafar Malmir ◽  
Amin Talebi ◽  
Mahdi Bodagh ◽  
Fatemeh Malasadi
Keyword(s):  
Small Intestine ◽  
Blunt Trauma ◽  
Diaphragmatic Rupture ◽  
Intestinal Injury ◽  
Greater Omentum ◽  
Rare Type ◽  
Traumatic Diaphragmatic Rupture ◽  
Abdominal Organs ◽  
Left Diaphragm ◽  
Daunting Task

Traumatic Diaphragmatic Rupture (TDR) is a rare type of trauma. Small intestine injuries are the third most common type of injury resulting from blunt trauma to abdominal organs. The immediate diagnosis of TDR and bowel injuries is a daunting task. We reported a 53-year-old male patient who was transferred to the hospital by EMS because of a car accident. The chest X-ray showed the left diaphragm elevation. Also, a computed tomography scan revealed that the greater omentum, a portion of the colon, spleen, and stomach were transposed in the hemithorax through a diaphragm rupture. The patient underwent laparotomy and the incidental findings in laparotomy showed bowel injuries. This case was a common cause of traumatic left-sided diaphragmatic rupture and intestinal injury. The suspicion of diaphragmatic rupture and intestinal injury in a patient with multiple traumas contributes to early diagnosis. Surgical repair remains the only treatment for diaphragmatic rupture. The severe injury in a part of the intestine may result in the resection of that part.

scholarly journals Delayed Presentation of Traumatic Diaphragmatic Rupture with Herniation of the Left Kidney and Bowel Loops

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Amiya Kumar Dwari ◽  
Abhijit Mandal ◽  
Sibes Kumar Das ◽  
Sudhansu Sarkar
Keyword(s):  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Major Trauma ◽  
Left Kidney ◽  
Diaphragmatic Rupture ◽  
Delayed Presentation ◽  
Traumatic Diaphragmatic Hernia ◽  
Traumatic Diaphragmatic Rupture ◽  
A Minor

Rupture of the diaphragm mostly occurs following major trauma. We report a case of delayed presentation of traumatic diaphragmatic hernia on the left side in a 44-year-old male who presented two weeks after a minor blunt trauma. Left kidney and intestinals coils were found to herniate through the diaphragmatic tear. This case demonstrates the importance of considering the diagnosis in all cases of blunt trauma of the trunk. It also illustrates the rare possibility of herniation of kidney through the diaphragmatic tear.

scholarly journals The Role of CT Scan in Recognizing Blunt Diaphragmatic Rupture

2012 ◽  
Vol 1 (1) ◽  
pp. 24-26
Author(s):  
Edward Passos ◽  
Bartolomeu Nascimento ◽  
Fernando Spencer Netto ◽  
Homer Tien
Keyword(s):  
Ct Scan ◽  
Blunt Trauma ◽  
New Technologies ◽  
Motor Vehicle ◽  
Diaphragmatic Rupture ◽  
High Morbidity ◽  
Trauma Patients ◽  
Ct Scanner ◽  
Traumatic Diaphragmatic Rupture

ABSTRACT Background Blunt traumatic diaphragmatic rupture (BTDR) occurs when signicant deceleration mechanism and energy are applied to the torso, and it is associated with signicant injuries and high morbidity and mortality. Although it has limitations, CT scan is the diagnostic of choice for BTDR. This study is a retrospective analyse of our experience in diagnosing BTDR using the 64-slice CT scanner. Sensitivity and specicity of this exam were assessed. Methods We reviewed reports from 2006 to 2009 of all CT scans of the abdomen that were done in the rst 24 hours of hospitalization of blunt trauma patients. We compared CT ndings to surgery reports. Results Our cohort consisted of 2670 patients; 69% were male. We found 28 cases of BTDR, most of them on the patient s left side (54%). Eleven percent of cases were bilateral. BTDR was often caused by motor vehicle collisions. We found sensitivity of 86%, specicity of 99%. Conclusion CT scan is reliable tool in blunt trauma patients. As new technologies arise, its sensibility and specicity also increases. How to cite this article Passos E, Nascimento B, Netto FS, Tien H, Rizoli S. The Role of CT Scan in Recognizing Blunt Diaphragmatic Rupture. Panam J Trauma Critical Care Emerg Surg 2012;1(1):24-26.

scholarly journals Traumatic Diaphragmatic Rupture, Incidence, Presentation, and Outcome: تمزق الحجاب الحاجز الرضحي؛ مدى شيوع الإصابة والعرض والنتيجة

2021 ◽  
Vol 5 (3) ◽  
pp. 98-84
Author(s):  
Waleed Mohammed Gialan, Yasser Abdurabu Obadiel, Abdulrazzak Waleed Mohammed Gialan, Yasser Abdurabu Obadiel, Abdulrazzak
Keyword(s):  
Prospective Study ◽  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Penetrating Trauma ◽  
Length Of Hospital Stay ◽  
Diaphragmatic Rupture ◽  
Associated Injuries ◽  
Traumatic Diaphragmatic Rupture ◽  
The Right ◽  
Time Of Presentation

Objective: The aim of this prospective study is to highlight the incidence of a traumatic diaphragmatic rupture occurring in thoraco-abdominal penetrating or blunt trauma, and discuss their presentation and outcome Methods: We performed a prospective study, between 1st January 2017 to 30th June 2020 at the Department of General Surgery of the Al-Thawra Modern General Hospital, and 48-Modrn hospital -Sana'a city -Yemen. We included all the patients who were diagnosed and admitted with traumatic diaphragmatic rupture during the study period. Data included demographics, mechanism of injury, associated injuries, time of presentation post- trauma, length of hospital stay and ICU, ventilator days, management, postoperative complication, and outcomes. The variables were analyzed and compared for patients. Result: A total of 38 patients had traumatic diaphragmatic injury of (1843) thoracoabdominal trauma (2.1%)(855 blunt trauma & 988 penetrating trauma), 31 patients (81.6%) have sustained penetrating trauma, while only 7 patients (18.4%) have blunt trauma. There were 33 male patients (86.8%) and 5 female patients (13.2%) with a mean age of 25 years (range 3–52 years), the location of rupture was 30 patients (78.9%) on the left-sided, and 8 patients (21.1%) on right-sided, 4 patients presented early with a diaphragmatic hernia, and 5 patient presented late with diaphragmatic hernia. Associated injuries were presented in 36 patients (94.7%). The diagnosis was preoperatively established in (36.8%), and intraoperative (63.2%). The diaphragmatic rupture was repaired with interrupted nonabsorbable sutures. Postoperative complications were observed in 23 patients (60.5%). Mortality was observed in 4 patients (10.5%). The outcome affected by associated injuries hemo/pneumothorax, rib fractures/lung contusion, hollow viscous injury, post-operative complication, time of presentation post- trauma, and hemodynamically state before admission. Conclusion: Traumatic diaphragmatic rupture, usually masked by multiple associated injuries which aggravate the condition of patients and are responsible for morbidity and mortality. The left-sided is involved more than the right-sided.

scholarly journals Strangulated Tension Viscerothorax with Gangrene of the Stomach in Missed Traumatic Diaphragmatic Rupture

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Uvie Onakpoya ◽  
Akinwumi Ogunrombi ◽  
Anthony Adenekan ◽  
William Akerele
Keyword(s):  
Treatment Outcomes ◽  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Anterior Wall ◽  
Diaphragmatic Rupture ◽  
The Body ◽  
Rare Occurrence ◽  
Traumatic Diaphragmatic Rupture ◽  
Poor Treatment ◽  
Diaphragmatic Hernias

Acquired diaphragmatic hernias are usually posttraumatic in occurrence. In patients who have blunt trauma and associated diaphragmatic hernia, the diagnosis may be missed or delayed, often leading to poor treatment outcomes. We present a rare occurrence of tension viscerothorax due to missed traumatic diaphragmatic rupture in a 25-year-old woman whose condition was complicated by gangrene and perforation of the fundus as well as questionable viability of the anterior wall of the body of the stomach. The patient had a successful emergency transabdominal suture plication of the diaphragm and gastroplasty and has remained symptomless 3 months postoperatively.

scholarly journals Diaphragmatic rupture with right colon and small intestine herniation after blunt trauma: a case report

2010 ◽  
Vol 4 (1) ◽  
Author(s):  
Mirko Muroni ◽  
Giuseppe Provenza ◽  
Stefano Conte ◽  
Andrea Sagnotta ◽  
Niccolò Petrucciani ◽  
...  
Keyword(s):  
Small Intestine ◽  
Case Report ◽  
Blunt Trauma ◽  
Diaphragmatic Rupture ◽  
Right Colon

Bilateral Diaphragmatic Rupture due to Blunt Trauma—A Rare Injury

1978 ◽  
Vol 18 (4) ◽  
pp. 280-282 ◽  
Author(s):  
LESTER R. BRYANT ◽  
FREDERICK G. SCHECHTER ◽  
RILEY REES ◽  
HAROLD M. ALBERT
Keyword(s):  
Blunt Trauma ◽  
Diaphragmatic Rupture ◽  
Rare Injury

Trauma to the Abdomen and Pelvis

2018 ◽  
Author(s):  
Zahir Basrai ◽  
Timothy Jang ◽  
Manuel Celedon
Keyword(s):  
Blunt Trauma ◽  
Abdominal Trauma ◽  
Peritoneal Lavage ◽  
Penetrating Trauma ◽  
Balloon Occlusion ◽  
Organ Injury ◽  
Abdominal Organs ◽  
Fast Exam ◽  
Definitive Management ◽  
Endovascular Balloon Occlusion

Abdominal trauma accounts for approximately 12% of all trauma. The evaluation of abdominal trauma is difficult as the patient may have concomitant distracting injuries or alteration of mental status. As a result, a systematic approach to abdominal trauma is needed to ensure that life threatening injuries are not missed. The evaluation and management of abdominal trauma is directed by the Western and Eastern Trauma Association guidelines. Trauma to the abdomen is divided into two main categories, penetrating and blunt. The initial steps in management of both types are determined by the hemodynamic stability of the patient. Unstable patients with either pattern of injury are emergently taken to the operating room (OR) for exploration. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is being used at select trauma centers in unstable patients with abdominal trauma that are unresponsive to standard trauma resuscitation. For hemodynamically stable patient with penetrating trauma, recent data on selective non-operative management has shown promising outcomes. Patients with tenuous hemodynamics and blunt abdominal trauma are resuscitated with blood transfusions while being worked up by a Focused Assessment with Sonography for Trauma (FAST) exam or deep peritoneal lavage (DPL). If the patient stabilizes further work up with labs and imaging is performed. Patients that remain tenuous should be taken to the OR. Hemodynamically stable patients with blunt trauma and evidence of peritonitis on exam can be evaluated with labs and imaging to assess for organ injury. Non- tender patients can be evaluated with labs and serial abdominal exams. The American Association for the Surgery of Trauma (AAST) organ injury scales are used to guide the definitive management of patients with intraabdominal injury. The Young-Burgess Classification System can be used to characterize pelvic fractures and to guide stabilization and definitive management. Tables demonstrate the AAST Injury Scales for the different abdominal organs. Images demonstrate the FAST exam and CT findings for different abdominal organs.   This review contains 14 figures, 6 tables and 48 references Key Words: Abdominal Trauma, Penetrating Trauma, Blunt Trauma, FAST exam, Liver Trauma, Splenic Trauma, Intestinal Trauma, Pancreatic Trauma, Diaphragmatic Trauma, Aortic Trauma, Pelvic Fracture, Deep peritoneal lavage, DPL, Focused Assessment with Sonography for Trauma, REBOA, Resuscitative Endovascular Balloon Occlusion of the Aorta

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