Isolated Left Sided Diaphragmatic Injury Due to Blunt Trauma, Images for Clinicians

Yıl 2014, , - , 01.09.2014

Ömer Faruk Özkan Faruk Özkul Ali Guner Arif Burak Cekic Ayhan Cagılcı

https://doi.org/10.15197/sabad.1.11.70

Öz

Diafragmatic injury presents acutely and be associated with other life threatening injury of other organs. Sudden increase in abdominal pressure may cause injury in the membranous or muscular part of the diaphragm. While isolated diaphragmatic rupture after blunt trauma is rarely seen, its diagnosis can be overlooked frequently. Early diagnosis is the most important step in the treatment. Cases with delayed diagnosis can result in a diaphragmatic hernia with high mortality and morbidity rates due to complications such as strangulation and incarceration. The most critical point during the diagnosis is the suspicion for clinical diaphragm injury. X-ray graphy and computed tomography can be a guide for identifying diaphragmatic injuries. In this case report we presented an isolated left side diaphragmatic rupture after blunt abdominal trauma and treated with an urgent surgical operation.

Anahtar Kelimeler

Diaphragmatic injury, blunt trauma, images

Isolated Left Sided Diaphragmatic Injury Due to Blunt Trauma, Images for Clinicians

Öz

Diyafragma yaralanmaları, genellikle hayatı tehdit eden diğer organ yaralanmalarına eşlik etmektedir. Karın içi basıncın ani olarak artışına neden olan etkenler, diyaframın membranöz ve musküler bölümünde hasara neden olabilmektedir. Künt travmalar sonrası, izole diyafram yaralanmaları nadir görülmekle beraber, gözden kaçabilmektedir. Erken tanı tedavideki en önemli aşamayı oluşturmaktadır. Tanının atlanması, stragülasyon ve inkarserasyona bağlı mortalitenin yüksek olduğu diyafram hernilerine neden olabilmektedir. Tanıda en önemli aşama diyafram yaralanmasından şüphelenilmesi olup, direk grafi ve bilgisayarlı tomografi diyafram yaralanmasında tanıda yol gösterici olabilmektedir. Çalışmamızda, künt karın travması sonrası izole diyafram yaralanması saptanan ve tedavi edilen hastanın sunulması amaçlanmıştır

Anahtar Kelimeler

Diyafragma hasarı, künt travma, görüntüler

Kaynakça

• Celik A, Altinli E, Köksal N, et al. Diagnostic process and management of diaphragmatic injuries: approach in patients with blunt and penetrating trauma. National Trauma Emerg Surg J (Turkish) 2010;16(4):339-43
• Boulanger BR, Milzman DP, Rosati C, Rodriguez A. A com- parison of right and left blunt traumatic diaphragmatic rupture. J Trauma 1993;35(2):255-60.
• Hsee L, Wigg L, Civil I. Diagnosis of blunt traumatic rup- tured diaphragm: is it still a difficult problem?. ANZ J Surg 2010;80(3):166-8.
• Guner A, Ozkan OF, Bekar Y, Kece C, Kaya U, Reis E. Management of delayed presentation of a right- side traumatic diaphragmatic rupture. World J Surg 2012;36(2):260-5.
• Wilson RF, Bender JS. Diaphragmatic injuries. In: Wilson RW, Walt AJ (eds). Management of Trauma. Philadelphia: Williams & Wilkins,1996:432–48.
• Wadhwa A, Surendra J, Sharma A, et al. Laparoscopic Repair of Diaphragmatic Hernias:Experience of Six Cases. Asian journal of surgery 2005;28(2):145-50
• Lomoschitz FM, Eisenhuber E, Linnau KF, Peloschek P, Schoder M, Bankier AA. Imaging of chest trauma: radio- logical patterns of injury and diagnostic algorithms. Eur J Radiol 2003;48:61-70.
• Williams M, Carlin AM, Tyburski JG, et al. Predictors of mortality in patients with traumatic diaphragmatic rup- ture and associated thoracic and/ or abdominal injuries. Am Surg 2004;70: 157-62.
• Shanmuganathan K, Killeen K, Mirvis SE, et al. Imaging of diaphragmatic injuries. J Thorac Imaging. 2000; 15: 104.
• Murray JG, Caoili E, Gruden JF, Evans SJ, Halvorsen RA Jr, Mackersie RC.Acute rupture of the diaphragm due to blunt trauma: diagnostic sensitivity and specificity of CT. AJR Am J Roentgenol 1996;166(5):1035-9.