Taş İlhan, Yiğit Ebral
Department of General Surgery, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey.
Singapore Med J. 2025 Jun 1;66(6):333-337. doi: 10.4103/singaporemedj.SMJ-2022-076. Epub 2023 Sep 25.
Diaphragm rupture (DR) is a rare pathological event usually caused by trauma. We aimed to analyse the characteristics of acute diaphragmatic injuries due to trauma and the treatment of such injuries.
This study included the data of 15 patients who sustained diaphragmatic injuries due to trauma and underwent surgery at the Diyarbakır Gazi Yaşargil Training and Research Hospital General Surgery Service between January 2016 and December 2019.
There were 240 patients who presented with abdominal trauma during the study period, and DR was detected in 15 (6.25%) of these patients. The male to female ratio was 14 to 1, and the average age of the patients was 29.66 ± 10.56 (15-46) years. The most common cause of diaphragmatic injury was penetrating abdominal injuries (86.7%). Blunt abdominal trauma accounted for 13.3% of the DR cases. Preoperative shock was present in four (26.7%) patients. Preoperative diagnosis was made in only one (6.7%) of 15 patients with DR. Other patients were diagnosed during operation. Thirteen (86.7%) patients had additional organ injuries, and two patients had isolated diaphragmatic injuries. The most frequently injured organ was the lung ( n = 7, 46.6%). Complications developed in six patients (morbidity rate 40%), and pulmonary complications were most frequently encountered ( n = 5, 33.3%). The mortality rate was 6.7%.
As traumatic DRs are uncommon and often associated with additional organ injuries, a careful general assessment of the patient should be made.
膈肌破裂(DR)是一种罕见的病理事件,通常由创伤引起。我们旨在分析创伤性急性膈肌损伤的特征及此类损伤的治疗方法。
本研究纳入了2016年1月至2019年12月期间在迪亚巴克尔加齐·亚萨尔吉尔培训与研究医院普通外科接受手术治疗的15例创伤性膈肌损伤患者的数据。
研究期间共有240例腹部创伤患者,其中15例(6.25%)被检测出膈肌破裂。男女比例为14比1,患者平均年龄为29.66±10.56(15 - 46)岁。膈肌损伤最常见的原因是穿透性腹部损伤(86.7%)。钝性腹部创伤占膈肌破裂病例的13.3%。4例(26.7%)患者术前出现休克。15例膈肌破裂患者中只有1例(6.7%)术前得到诊断。其他患者在手术中被诊断。13例(86.7%)患者伴有其他器官损伤,2例患者为单纯膈肌损伤。最常受伤的器官是肺(n = 7,46.6%)。6例患者出现并发症(发病率40%),最常见的是肺部并发症(n = 5,33.3%)。死亡率为6.7%。
由于创伤性膈肌破裂并不常见且常伴有其他器官损伤,应对患者进行仔细的全面评估。