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Blunt traumatic diaphragmatic rupture

Antonio Carlos Nogueira, Munir Bazzi, Francisco Garcia Soriano, Haydée Jordão, Sueli Vieira Lopes, Sebastião Pontes, Ana Carolina Makino Antunes, João Augusto dos Santos Martines


Traumatic injury of the diaphragm ranges from 0.6 to 1.2% and rise up to 5%
among patients who were victims of blunt trauma and underwent laparotomy.
Clinical suspicion associated with radiological assessment contributes to early
diagnosis. Isolated diaphragmatic injury has a good prognosis. Generally
worse outcomes are associated with other trauma injuries. Bilateral and
right diaphragmatic lesions have worse prognosis. Multi detector computed tomography (MDCT) scan of the chest and abdomen provides better diagnostic
accuracy using the possibility of image multiplanar reconstruction. Surgical
repair via laparotomy and/ or thoracotomy in the acute phase of the injury has
a better outcome and avoids chronic complications of diaphragmatic hernia.
The authors present the case of a young male patient, victim of blunt abdominal
trauma due to motor vehicle accident with rupture of the diaphragm, spleen
and kidney injuries. The diagnosis was made by computed tomography of the
thorax and abdomen and was confirmed during laparotomy.


Diaphragm; Hernia; Laparotomy; Wounds and injuries.

DOI: http://dx.doi.org/10.4322/acr.%25y.26066

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