Diagnostic and therapeutic problems of recent traumatic diaphragmatic ruptures
Andreassian, B.; Salmon, R.; Roger, W.; Parmentier, G.; Parrot, A.M.; Baumann, J.
Annales de Chirurgie 34(4): 284-289
1980
ISSN/ISBN: 0003-3944 PMID: 7387112 Document Number: 159807
Emergency cases (37) of diaphragmatic ruptures due to closed trauma were treated. This study concerns especially multitraumatisms in which associated visceral and bone injuries are common. Thirty cases were immediately diagnosed and treated. During the 1st wk there were 4 secondary diagnostics and also 3 ignored ruptures revealed later by acute complications. Diagnostic difficulties are due to the lack of a characteristic radiologic sign and to the presence of traumatic pleuro-pulmonary lesions. It was necessary to complete the investigations using digestive Ba studies, and peritoneal dialysis. All these studies can be insufficient or false. Death (5 cases) depends principally on the gravity of the associated injuries of the multitraumatisms. Cardiopericardial complications were isolated: acute cardiac failure and secondary pericardial effusion. It is necessary to make clinical, radiological, electrical and echocardiographical tests. The treatment of these cardiopericardiac complications depends on hemodynamics. No important ventilatory sequela were found in any controlled patients. The affected diaphragm conserves all its mobility.