Penetrating left thoracoabdominal trauma : The incidence and clinical presentation of diaphragm injuries.
The objective of this study was to (1) determine the incidence of diaphragmatic injuries in penetrating left thoracoabdominal trauma and (2) evaluate the role of laparoscopy in detecting clinically occult diaphragmatic injuries.
Patients and Methods
One hundred nineteen consecutive patients with penetrating injuries to the left thoracoabdominal region presenting to Los Angeles County-University of Southern California Medical Center were prospectively evaluated during an 8-month period.
Either celiotomy (with hemodynamic instability or peritonitis) or laparoscopy was performed.
Results of the clinical examination and roentgenographic findings were recorded preoperatively.
One hundred seven patients were fully evaluated.
Fifty patients required emergent celiotomy
Fifty-seven patients underwent laparoscopy.
The overall incidence of diaphragmatic injuries was 42% (59% for gunshot wounds, 32% for stab wounds).
Among the 45 patients with diaphragmatic injuries, 31% had no abdominal tenderness, 40% had a normal chest roentgenogram, and 49% had an associated hemopneumothorax.
Fifteen of the patients undergoing laparoscopy (26%) had occult diaphragm injuries.
(1) The incidence of diaphragmatic injuries in association with penetrating left thoracoabdominal trauma is high. (2) The clinical and roentgenographic findings are unreliable at detecting occult diaphragmatic injuries. (...)
Mots-clés Pascal : Plaie pénétrante, Arme à feu, Arme blanche, Traumatisme, Abdomen, Association, Thorax, Complication, Perforation, Diaphragme, Symptomatologie, Epidémiologie, Incidence, Etude longitudinale, Homme, Abdomen pathologie, Appareil respiratoire pathologie, Système ostéoarticulaire pathologie
Mots-clés Pascal anglais : Penetrating injury, Fire arm, Side arm, Trauma, Abdomen, Association, Thorax, Complication, Perforation, Diaphragm, Symptomatology, Epidemiology, Incidence, Follow up study, Human, Abdominal disease, Respiratory disease, Diseases of the osteoarticular system
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0002161
Code Inist : 002B16G. Création : 17/04/1998.