Managementul leziunilor traumatice diafragmatice

Abstract

Introducere: Leziunie diafragmatice traumatice sunt rare si pot fi identificate prin intermediul radiografiilor toracice si al computer tomografiilor si sunt tratate chirurgical prin laparotomie folosind suturi nonabsorbabile. Leziunea initiala este de cele mai multe ori mascata de prezenta unor leziuni concomitente la nivel toracic sau abdominal. Pacienti si metoda: Pentru realizarea articolului au fost folosite datele medicale ale pacientilor internati cu traumatisme toracice sau abdominale in Spitalul Clinic de Urgenta Bucuresti in perioada 2017-2022 Rezultate: Au fost identificati 14 pacienti cu leziuni traumatice diafragmatice, 10 erau barbati si 4 erau femei. Scorul de severitate lezionala mediu a fost de 16. Metoda de diagnosticare majoritara a fost reprezentata de computer tomografie , 9 pacienti fiind diagnosticati astfel, 4 au fost diagnosticati prin intermediul unei radiografii toracice si 1 pacient a fost diagnosticat cu leziune diafragmatica in timpul operatiei. Localizarea traumei a fost pe partea stanga in cazul a 10 pacienti, iar 4 pacienti au prezentat leziune diafragmatica dreapta. Din totalul de 14 leziuni, 10 erau de natura nepenetranta si 4 erau de natura penetranta.

Background: Traumatic diaphragmatic injury (TDI) is uncommon and can be identified by chest x-rays and CT scans and is repaired by laparotomy with nonabsorbable suture. The initial injury is often obscured by concurrent thoracic and abdominal injuries. Patients and methods: The medical records of patients admitted to Bucharest Clinical Emergency Hospital with thoracic or abdominal trauma from 2017 to 2022 were reviewed. Results: A total of 14 patients were identified with TDI, 10 of them were men and 4 women. The median Injury Severity Score (ISS) was 16. The diagnostic method of the TDI was mostly represented by a CT scan, 9 patients being diagnosed this way, while 4 were diagnosed by chest x-rays and only 1 patient was diagnosed during a laparotomy. The location of the trauma was on the left side for 10 patients and only 4 patients had a right sided TDI. Out of 14 TDIs, 10 were blunt TDIs and 4 were penetrating TDIs.