Blunt traumatic diaphragmatic injury: A diagnostic enigma with potential surgical pitfalls.
Am J Emerg Med
; 35(2): 214-217, 2017 Feb.
Article
em En
| MEDLINE
| ID: mdl-27802875
ABSTRACT
BACKGROUND:
Blunt traumatic diaphragmatic injury (BTDI) is an uncommon injury and one which is difficult to diagnose. The objective of this study was to identify features associated with this injury.METHODS:
This was a retrospective study based on records of 354307 blunt trauma victims treated between 1998 and 2013 collected by the Israeli National Trauma Registry.RESULTS:
BTDI was reported in 231 (0.065%) patients. Motor vehicle accidents were responsible for 84.4% of the injuries 97 (42.0%) were reported as drivers; 54 (23.4%) were passengers; 34 (14.7%) were pedestrians hit by cars; and 10 (4.3%) were on motorcycles. There were more males than females (2.51) compared with blunt trauma patients without BTDI (p<.001). Patients with BTDI were significantly younger than blunt trauma patients without BTDI (p<.001). ISS was 9-14 in 5.2%, 16-24 in 16.9%, 25-75 in 77.9%. Urgent surgery was performed in 62% of the patients and 79.7% had surgery within 24h of admission. Mortality was 26.8%. Over 40% of patients with BTDI had associated rib, pelvic and/or extremity injuries. Over 30% had associated spleen, liver and/or lung injuries. Nevertheless, less than 1% of patients with skeletal injuries and less than 2.5% with solid organ injuries overall had associated BTDI. Despite hollow viscus injury being less prevalent, up to 6% of patients with this injury had associated BTDI.CONCLUSIONS:
BTDI is infrequent following blunt trauma. Hollow viscus injuries were more predictive of BTDI than skeletal or solid organ injuries.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Ferimentos não Penetrantes
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Diafragma
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Traumatismo Múltiplo
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Child
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Female
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Humans
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Male
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Middle aged
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article