둔상선 외상에 의한 횡경막 손상

From August 1988 to Febrary 1992, the records of 16 patients who sustained diaphragmatic rupture from blunt trauma were seen at Dongkuk University Hospital. The mean age for all of the patients was 37.5 years, with a range of 18 to 80 years and Male was predominant(M: F=10: 6). The ruptured sites were located on the left in 12 patients and on the right in 4 paitents. The most common symptoms were dyspnea and chest pain(75%). Traumatic diaphragmatic hernia(TDH) were suspected on the basis of an abnormal chest X-ray findings in the trauma victim with multiple injuries. The 13 cases of 16 patients(81%) were diagnosed and treated within 24 hours after the blunt trauma. The operative approaches of 15 cases were performed with abdominal approaches in 8 cases, thoracic approaches in 4 cases and thoraco abdominal approaches in 3 cases. There were 2 deaths(12.5%) from uncontrolled blood loss and multiple associated injuries. Postoperative complications, most frequently pulmonary problem, developed in 5 cases(35.7%). More aggressive resuscitative efforts and earlier control of bleeding have seen to provide better chances for improved survivial.