Leziuni traumatice diafragmatice | [Diaphragmatic injuries]

Abstract

Diaphragmatic injuries (TDI) represent a serious pathology due to the absence of simptomathology, respiratory and digestive disfunctions, and difficulties in setting the diagnosis and choosing the approach mode. Material and method: The charts of the 24 patients admitted in Brasov County Hospital and treated for TDI from 1.04.1994 – 1.10.2005 were reviewed. Results: Males prevailed (19). etiology was car crashes and work accidents. Symptoms were digestive in 6 cases, thoracic in 8 cases, and thoraco-abdominal in 6 cases, and in 4 cases, it was absent. The diagnosis was preoperatively established in 12 cases: radiology (rdg) - 9, rdg and US– 2, rdg + barium – 1, intraoperatively in 11 cases and at autopsy in 1 case. The decision for operation was made in the acute phase on 21 patients, as planned in 2 cases, and in the obstruction or strangulation phase in 7 patients. The approach mode was thoracic – 7 patients, abdominal – 7 patients, combined – 9 patients. Phrenoraphy was the constant technical solution. It was associated in 9 patients with specific techniques for the special injuries. 6 deceases were registered early with patients with politraumatism. Conclusions: TDI must be suspected in patients with atypical symptomatology after an accident. Chest radiography and CT are the best methods for the diagnosis of TDI. Operation is indicated in early emergency for diaphragmatic wounds and in postponed emergency for diaphragmatic ruptures. The prognosis is good except for patients with politraumatisms.