We evealuated fifty cases of traumatic diaphragmatic injuries that we have experienced from Jan. 1973 to Oct. 1994. The age distribution of the pateint was ranged from 1 to 74 years. Sex ratio is 38:14 with male dominence.
The traumatic diaphragmatic injuries were due to blunt trauma in 37 (left 22, Right 15) cases and penetrating trauma in 16 (Left 9, Right 7) cases.
In blunt trauma, preoperative diagnosis of the diaphragmatic injuries was possible in 27 patients (72%), and in penetrating trauma, 14 patients (88%).
Among 37 in blunt traumas, 22 (58%) cases, and among 16 in penetrating traumas, 13 (88%) cases were operated within 24 hours.
The most common herniated abdominal organ in the thorax was stomach (14/53).
The traumatic diaphragmatic repair of 50 cases were performed by thoracic approach in 23 cases, thoracoabdominal approach in 8 cases and abdominal approach in 19 cases, and in 3 cases, not operated.
Hospital mortality (including not operated patients (3) was 17% (9/53) and the causes of death were intracranial hematoma (1), hypertensive encephalopathy (1) and asphyxia (1), and among operated patients (6), combined head injury (2), multiorgan
failure (2), hypovolemic shock (2), hypovolemic shock (1), and pulmonary edema & renal failure (1). All deaths had related to the severity of associated injuries.
(Korean J Thorac Cardiovasc Surg 1995;28:1167-73)
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