둔상에 의한 외상성 횡경막파열

A Retrospective study of 42 patients with diaphragm injuries from blunt trauma during the past five years was undertaken. Twenty six patients (61%) had left diaphragm injuries, and thirteen patients (31%) had right diaphragm injuries. Bilateral diaphragm injuries were found in three patients. Early diagnosis was made in 36 patients by chest X-ray, diagnostic peritoneal lavage, CT scan, or clinical examination. Chest X-ray was the most common method of diagnosis (17 patients), followed by discovery at laparotomy triggered by positive diagnostic peritoneal lavage (12 patients). No right diaphragm injury was identified on chest X-ray, but chest X-ray was diagnostic in 17/26 patients (65%) with left diaphragm injuries. Right diaphragm injuries were associated with more severe trauma (lower GCS and RTS, higher ISS). Virtually all patients had associated injuries, with abdomen being the most common body region involved (71%). We conclude t,hat blunt diaphragm injury is itself rarely a cause of death, but rather a marker of severe injury.