Diaphragmatic Trauma About 14 Cases

Abstract

Introduction: Traumatic injury or rupture of the diaphragm is a rare consequence of thoracic and abdominal trauma. The aim of this study was to determine the epidemiological profile, the etiological mechanisms, the elements of the diagnosis, as well as the therapeutic modalities. Patients and Methods: This was a retrospective study carried out in the visceral surgery department of the Mohammed VI University Hospital of Marrakech over a period of 5 years between January 2017 and December 2022. Epidemiological parameters, clinical characteristics, treatment and prognosis of patients operated for diaphragm trauma were studied. Results: Fourteen patients with diaphragmatic trauma were operated on. Road accidents were the most representative etiological mechanism with 71% of cases (10 cases out of 14), including cars, motorcycles and pedestrians, For the remaining 4 cases, the rupture occurred following falls with basithoracic reception in 2 cases and following a thoraco-abdominal penetrating wound in 2 cases. The rupture involved the left diaphragmatic dome in eight cases, the right dome in four cases and it was bilateral in two patients. The diagnosis was confirmed in pre-operation by different imaging techniques, in particular computed tomography and in two cases by MRI. Essentially by the median route, treatment consisted of closure of the diaphragmatic breach by simple sutures and in some patients, the use of prosthetic equipment was indicated. Conclusion: Diaphragmatic ruptures occupy a special place in traumatology. They are evidence of severe trauma. They are sometimes unrecognized, either because of dominant associated lesions or because of the povertý of clinical signs and the low sensitivitý of common paraclinical examinations.