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. 2019:61:82-85.
doi: 10.1016/j.ijscr.2019.07.030. Epub 2019 Jul 19.

Double traumatic diaphragmatic injury: A case report

Dario Iadicola  1 , Massimo Branca  2 , Massimo Lupo  2 , Eugenia Maria Grutta  3 , Stefano Mandalà  4 , Gianfranco Cocorullo  5 , Antonino Mirabella  2
Affiliations

Double traumatic diaphragmatic injury: A case report

Dario Iadicola et al. Int J Surg Case Rep. 2019.

Abstract

Introduction: Traumatic diaphragmatic injuries are rare complications resulting from a thoracic-abdominal blunt or penetrating trauma. Left-sided diaphragmatic injuries are more commonly reported in literature. Bilateral injuries are extremely rare, occurring in about 3% of the patients and just few cases reported in literature. Traumatic diaphragmatic hernias are definitely a marker of a severe trauma, in fact diaphragmatic injuries are often related to thoracic and abdominal organs injuries. Sometimes the classic clinical signs and symptoms of diaphragmatic injuries may initially not be present so that definitive evaluation is delayed or even missed.

Case report: A 62-years old woman was admitted in Emergency Department after a pedestrian accident. A whole-body CT scan showed multiple fractures (ribs, pelvic and vertebral) but no organ injury. The next CT detected a left-sided posterior diaphragmatic hernia involving transverse colon. Thus we performed an explorative laparoscopy and found a double diaphragmatic injury. A primary repair with non-absorbable sutures and a prosthetic titanized patch was performed.

Keywords: Abdomen; Diaphragmatic injury; Laparoscopy; Thorax; Titanized mesh; Tramautic diaphragmatic hernia; Trauma.

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Figures

Fig. 1
Fig. 1
Whole-body non-contrast CT scan (scout view): detection of left-sided posterior diaphragmatic hernia involving transverse colon.
Fig. 2
Fig. 2
Whole-body oral-contrast CT scan (coronal view with pulmonary window).
Fig. 3
Fig. 3
Double diaphragmatic injury.
Fig. 4
Fig. 4
Left-sided postero-lateral hernia.
Fig. 5
Fig. 5
Defects repaired with non-absorbable polypropylene suture.
Fig. 6
Fig. 6
Polypropylene mesh with titanized surface (TiMesh strong®, PFM Medical AG, Cologne, Germany) attached to the diaphragm.
See this image and copyright information in PMC

References

    1. Fair K.A., Gordon N.T., Barbosa R.R., Rowell S.E., Watters J.M., Schreiber M.A. Traumatic diaphragmatic injury in the American College of Surgeons National Trauma Data Bank: a new examination of a rare diagnosis. Am. J. Surg. 2015;209(May (5)):864–868. discussion 868-9. - PubMed
    1. Corbellini C., Costa S., Canini T., Villa R., Contessini Avesani E. Diaphragmatic rupture: a single-institution experience and literature review. Ulus. Travma Acil Cerrahi Derg. 2017;23(September (5)):421–426. - PubMed
    1. Zarour A.M., El-Menyar A., Al-Thani H., Scalea T.M., Chiu W.C. Presentations and outcomes in patients with traumatic diaphragmatic injury: a 15-year experience. J. Trauma Acute Care Surg. 2013;74(June (6)):1392–1398. quiz 1611. - PubMed
    1. Moore E.E., Malangoni M.A., Cogbill T.H., Shackford S.R., Champion H.R., Jurkovich G.J., McAninch J.W., Trafton P.G. Organ injury scaling. IV: thoracic vascular, lung, cardiac, and diaphragm. J. Trauma. 1994;36(March (3)):299–300. - PubMed
    1. Bosanquet D., Farboud A., Luckraz H. A review diaphragmatic injury. Respir. Med. CME. 2009;2:1–6.