Abstract
IntroductionTraumatic 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 reportA 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.
Highlights
Traumatic diaphragmatic injuries are rare complications resulting from a thoracicabdominal blunt or penetrating trauma
In selected patients, laparoscopic repair of diaphragmatic injuries is safe and feasible when performed by highly skilled surgeons [5,7,8,9,10]
Even though laparoscopic repair of diaphragmatic injuries is safe and feasible when performed by highly skilled surgeons, no attempt to repair complex injuries laparoscopically should be made, because of the potential risk of hazardous complications [7]
Summary
Traumatic diaphragmatic injuries are rare complications resulting from a thoracicabdominal 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, 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. A whole-body CT scan showed multiple fractures (ribs, pelvic and vertebral) but no organ injury. The CT detected a left-sided posterior diaphragmatic hernia involving transverse colon. 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
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