Abstract:
Purpose. Traumatic diaphragmatic rupture (TDR) is
associated with high rates of morbidity and mortality,
and the preoperative diagnosis is diffi cult.
Methods. Forty-eight patients with TDR were treated
in our department between January 2000 and May 2009.
The cause, location, size of rupture, associated morbidity
and mortality, surgical material for repair, and predictive
factors for overall outcome were evaluated.
Results. There were 41 male patients (85%) and 7
female patients (15%) with a mean age of 33.8 years
(range 17–69 years). Blunt trauma accounted for the
injuries of 15 patients (31%) and 33 patients (68%) had
penetrating injuries. The diagnosis was preoperatively
established in 12 patients (25%) with a plain chest X-ray
or/and computed tomography. The location of rupture
was on the left side of the diaphragm in 35 patients
(73%), on the right side in 10 (21%), and was bilateral
in 3 patients (6%). Traumatic diaphragmatic rupture
was repaired with interrupted nonabsorbable sutures or
polypropylene mesh (8 patients). Postoperative complications
were observed in 18 patients (38%). Overall
mortality was observed in 7 patients (15%). The mortality
was associated with hemorrhagic shock (P = 0.002),
a high injury severity score (P = 0.002), and having
additional injuries (P = 0.015).
Conclusion. The outcome of the patients is associated
with presence of hemorrhagic shock, a high injury severity
score, and additional organ injury.
