Rupture of the diaphragm after blunt trauma

W. C. Lee, R. J. Chen, J. F. Fang, C. C. Wang, H. Y. Chen, S. C. Chen, T. L. Hwang, L. B. Jeng, Y. Y. Jan, C. S. Wang, M. F. Chen, C. C. Lou, K. L. Wang, J. N. Lin

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective: To analyse our cases of acute rupture of the diaphragm after blunt trauma to find out how to diagnose it earlier and manage it more promptly in future. Design: Retrospective study of casenotes. Setting: Division of general surgery, district hospital, Taiwan. Patients: 50 Patients who presented with acute rupture of the diaphragm after blunt trauma during the 10 year period 1982-91. Main outcome measures: Morbidity and mortality. Results: The left hemidiaphragm was injured in 43 cases (86%), and the right in 7 (14%). The most common cause was road traffic accidents. 48 Patients had associated injuries, mainly to the chest and abdomen, and pelvic fractures. 44 Ruptured diaphragms were diagnosed before operation by chest radiography or upper gastrointestinal contrast examination. The transabdominal approach was the most appropriate, because 23 patients had intra-abdominal visceral injuries as well. 20 Patients (40%) had complications, and the rate was 33% among those treated within 24 hours and 70% among those whose treatment was delayed longer than 24 hours (p = 0.067). There were 3 deaths (6%); one patient died of empyema of the right chest as a result of simultaneous perforation of a hollow viscus. 6 Patients were permanently disabled by head and spinal injuries, and pelvic fractures. Conclusion: The prognosis of repairing diaphragmatic hernias is good as the disability rate is low. The diagnosis should be kept in mind in all patients with chest injuries, pelvic fractures, or abdominal injuries with hypoxaemia, as this will result in earlier treatment and improve diagnosis: The transabdominal approach is the most appropriate because it makes simultaneous abdominal injuries easier to treat. Correct operative management at an early stage will keep mortality to a minimum.

Original languageEnglish
Pages (from-to)479-483
Number of pages5
JournalEuropean Journal of Surgery, Acta Chirurgica
Volume160
Issue number9
Publication statusPublished - 1994
Externally publishedYes

Fingerprint

Diaphragm
Rupture
Wounds and Injuries
Abdominal Injuries
Thorax
Spinal Injuries
Thoracic Injuries
Empyema
Diaphragmatic Hernia
Viscera
District Hospitals
Mortality
Traffic Accidents
Taiwan
Craniocerebral Trauma
Radiography
Abdomen
Retrospective Studies
Outcome Assessment (Health Care)
Morbidity

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Lee, W. C., Chen, R. J., Fang, J. F., Wang, C. C., Chen, H. Y., Chen, S. C., ... Lin, J. N. (1994). Rupture of the diaphragm after blunt trauma. European Journal of Surgery, Acta Chirurgica, 160(9), 479-483.

Rupture of the diaphragm after blunt trauma. / Lee, W. C.; Chen, R. J.; Fang, J. F.; Wang, C. C.; Chen, H. Y.; Chen, S. C.; Hwang, T. L.; Jeng, L. B.; Jan, Y. Y.; Wang, C. S.; Chen, M. F.; Lou, C. C.; Wang, K. L.; Lin, J. N.

In: European Journal of Surgery, Acta Chirurgica, Vol. 160, No. 9, 1994, p. 479-483.

Research output: Contribution to journalArticle

Lee, WC, Chen, RJ, Fang, JF, Wang, CC, Chen, HY, Chen, SC, Hwang, TL, Jeng, LB, Jan, YY, Wang, CS, Chen, MF, Lou, CC, Wang, KL & Lin, JN 1994, 'Rupture of the diaphragm after blunt trauma', European Journal of Surgery, Acta Chirurgica, vol. 160, no. 9, pp. 479-483.
Lee WC, Chen RJ, Fang JF, Wang CC, Chen HY, Chen SC et al. Rupture of the diaphragm after blunt trauma. European Journal of Surgery, Acta Chirurgica. 1994;160(9):479-483.
Lee, W. C. ; Chen, R. J. ; Fang, J. F. ; Wang, C. C. ; Chen, H. Y. ; Chen, S. C. ; Hwang, T. L. ; Jeng, L. B. ; Jan, Y. Y. ; Wang, C. S. ; Chen, M. F. ; Lou, C. C. ; Wang, K. L. ; Lin, J. N. / Rupture of the diaphragm after blunt trauma. In: European Journal of Surgery, Acta Chirurgica. 1994 ; Vol. 160, No. 9. pp. 479-483.
@article{b811bd8107fe4dad9d1c4e78eec27d76,
title = "Rupture of the diaphragm after blunt trauma",
abstract = "Objective: To analyse our cases of acute rupture of the diaphragm after blunt trauma to find out how to diagnose it earlier and manage it more promptly in future. Design: Retrospective study of casenotes. Setting: Division of general surgery, district hospital, Taiwan. Patients: 50 Patients who presented with acute rupture of the diaphragm after blunt trauma during the 10 year period 1982-91. Main outcome measures: Morbidity and mortality. Results: The left hemidiaphragm was injured in 43 cases (86{\%}), and the right in 7 (14{\%}). The most common cause was road traffic accidents. 48 Patients had associated injuries, mainly to the chest and abdomen, and pelvic fractures. 44 Ruptured diaphragms were diagnosed before operation by chest radiography or upper gastrointestinal contrast examination. The transabdominal approach was the most appropriate, because 23 patients had intra-abdominal visceral injuries as well. 20 Patients (40{\%}) had complications, and the rate was 33{\%} among those treated within 24 hours and 70{\%} among those whose treatment was delayed longer than 24 hours (p = 0.067). There were 3 deaths (6{\%}); one patient died of empyema of the right chest as a result of simultaneous perforation of a hollow viscus. 6 Patients were permanently disabled by head and spinal injuries, and pelvic fractures. Conclusion: The prognosis of repairing diaphragmatic hernias is good as the disability rate is low. The diagnosis should be kept in mind in all patients with chest injuries, pelvic fractures, or abdominal injuries with hypoxaemia, as this will result in earlier treatment and improve diagnosis: The transabdominal approach is the most appropriate because it makes simultaneous abdominal injuries easier to treat. Correct operative management at an early stage will keep mortality to a minimum.",
author = "Lee, {W. C.} and Chen, {R. J.} and Fang, {J. F.} and Wang, {C. C.} and Chen, {H. Y.} and Chen, {S. C.} and Hwang, {T. L.} and Jeng, {L. B.} and Jan, {Y. Y.} and Wang, {C. S.} and Chen, {M. F.} and Lou, {C. C.} and Wang, {K. L.} and Lin, {J. N.}",
year = "1994",
language = "English",
volume = "160",
pages = "479--483",
journal = "British Journal of Surgery",
issn = "0007-1323",
publisher = "John Wiley and Sons Ltd",
number = "9",

}

TY - JOUR

T1 - Rupture of the diaphragm after blunt trauma

AU - Lee, W. C.

AU - Chen, R. J.

AU - Fang, J. F.

AU - Wang, C. C.

AU - Chen, H. Y.

AU - Chen, S. C.

AU - Hwang, T. L.

AU - Jeng, L. B.

AU - Jan, Y. Y.

AU - Wang, C. S.

AU - Chen, M. F.

AU - Lou, C. C.

AU - Wang, K. L.

AU - Lin, J. N.

PY - 1994

Y1 - 1994

N2 - Objective: To analyse our cases of acute rupture of the diaphragm after blunt trauma to find out how to diagnose it earlier and manage it more promptly in future. Design: Retrospective study of casenotes. Setting: Division of general surgery, district hospital, Taiwan. Patients: 50 Patients who presented with acute rupture of the diaphragm after blunt trauma during the 10 year period 1982-91. Main outcome measures: Morbidity and mortality. Results: The left hemidiaphragm was injured in 43 cases (86%), and the right in 7 (14%). The most common cause was road traffic accidents. 48 Patients had associated injuries, mainly to the chest and abdomen, and pelvic fractures. 44 Ruptured diaphragms were diagnosed before operation by chest radiography or upper gastrointestinal contrast examination. The transabdominal approach was the most appropriate, because 23 patients had intra-abdominal visceral injuries as well. 20 Patients (40%) had complications, and the rate was 33% among those treated within 24 hours and 70% among those whose treatment was delayed longer than 24 hours (p = 0.067). There were 3 deaths (6%); one patient died of empyema of the right chest as a result of simultaneous perforation of a hollow viscus. 6 Patients were permanently disabled by head and spinal injuries, and pelvic fractures. Conclusion: The prognosis of repairing diaphragmatic hernias is good as the disability rate is low. The diagnosis should be kept in mind in all patients with chest injuries, pelvic fractures, or abdominal injuries with hypoxaemia, as this will result in earlier treatment and improve diagnosis: The transabdominal approach is the most appropriate because it makes simultaneous abdominal injuries easier to treat. Correct operative management at an early stage will keep mortality to a minimum.

AB - Objective: To analyse our cases of acute rupture of the diaphragm after blunt trauma to find out how to diagnose it earlier and manage it more promptly in future. Design: Retrospective study of casenotes. Setting: Division of general surgery, district hospital, Taiwan. Patients: 50 Patients who presented with acute rupture of the diaphragm after blunt trauma during the 10 year period 1982-91. Main outcome measures: Morbidity and mortality. Results: The left hemidiaphragm was injured in 43 cases (86%), and the right in 7 (14%). The most common cause was road traffic accidents. 48 Patients had associated injuries, mainly to the chest and abdomen, and pelvic fractures. 44 Ruptured diaphragms were diagnosed before operation by chest radiography or upper gastrointestinal contrast examination. The transabdominal approach was the most appropriate, because 23 patients had intra-abdominal visceral injuries as well. 20 Patients (40%) had complications, and the rate was 33% among those treated within 24 hours and 70% among those whose treatment was delayed longer than 24 hours (p = 0.067). There were 3 deaths (6%); one patient died of empyema of the right chest as a result of simultaneous perforation of a hollow viscus. 6 Patients were permanently disabled by head and spinal injuries, and pelvic fractures. Conclusion: The prognosis of repairing diaphragmatic hernias is good as the disability rate is low. The diagnosis should be kept in mind in all patients with chest injuries, pelvic fractures, or abdominal injuries with hypoxaemia, as this will result in earlier treatment and improve diagnosis: The transabdominal approach is the most appropriate because it makes simultaneous abdominal injuries easier to treat. Correct operative management at an early stage will keep mortality to a minimum.

UR - http://www.scopus.com/inward/record.url?scp=0028146280&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028146280&partnerID=8YFLogxK

M3 - Article

C2 - 7849166

AN - SCOPUS:0028146280

VL - 160

SP - 479

EP - 483

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

IS - 9

ER -