Diagnosis of ruptured diaphragm following blunt trauma: Results from 85 cases

B. M. Smithers, O'Loughlin, B. and Strong, R. W. (1991) Diagnosis of ruptured diaphragm following blunt trauma: Results from 85 cases. Australian and New Zealand Journal of Surgery, 61 10: 737-741. doi:10.1111/j.1445-2197.1991.tb00142.x

Author B. M. Smithers
O'Loughlin, B.
Strong, R. W.
Title Diagnosis of ruptured diaphragm following blunt trauma: Results from 85 cases
Journal name Australian and New Zealand Journal of Surgery   Check publisher's open access policy
ISSN 0004-8682
Publication date 1991-10-01
Year available 1991
Sub-type Article (original research)
DOI 10.1111/j.1445-2197.1991.tb00142.x
Open Access Status
Volume 61
Issue 10
Start page 737
End page 741
Total pages 5
Place of publication Richmond, Vic., Australia
Publisher Wiley-Blackwell Publishing
Language eng
Abstract Between 1975 and 1990, 85 patients with diaphragmatic rupture following blunt trauma were treated at the royal brisbane and rincess alexandra hospitals, brisbane. There were 65 on the left, 17 on the right and three were bilateral. Road trauma was the cause in 88% of cases. In the first 48h the diagnosis was made by chest x-ray in 51 patients, lapamtomy in 22, autopsy in two, emergency room thoracotomy, ultrasound and pneumoperitoneum each in a single patient. Seven patients (8%) had delay in diagnosis greater than 48 h ranging from 6 days to 6 months. Diagnosis was subsequently made by pneumoperitoneum (3), chest x-ray (1) and exploratory thoracotomy (1). Two patients presented with a strangulated diaphragmatic hernia 3 and 6 months following an acute admission with blunt chest trauma and urological trauma respectively. During the study period a further five patients presented with an obstructing diaphragmatic hernia. Sixteen patients died (19%), fifteen from associated injuries and one related to the diaphragmatic repair. Ruptud diaphragm should be suspected in patients with severe chest trauma, particularly those requiring positive pressure ventilation, patients with intra-abdominal injuries and those with pelvic fractures. Early recognition and repair results in low morbidity and mortality. Measures that confirmed the diagnosis in patients with delay included repeated chest x-rays and pneumoperitoneum.
Keyword Blunt trauma
Ruptured diaphragm
Strangulated diaphragmatic hernia
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Mon, 18 Oct 2010, 19:19:02 EST