From January 1980 to July 1995, 32 patients with blunt diaphragmatic trauma and 12 with penetrating diaphragmatic trauma were treated at Kyungpook University Hospital. The mean age of patients with blunt trauma was 37.6 years, and with
penetrating
trauma 29.2 yea5s. The mean age was older in patients with blunt trauma by 8.4 years(p<0.05).
When simple chest X-ray diagnosis was performed, 24cases(75%) of the diaphragmatic injuries were found in blunt trauma and 4 case(33.3%) in penetrating trauma. When operations were done due to injuries of thoracic or abdominal organ, 7
diaphragmatic
injuries(58%) were found in penetrating trauma. Herniation occurred in 24 patients(75%) in blunt traumal and 5 patients(42%) in penetrating truma. The size of injured diaphragms in 29 cases in which hernia was discovered was 10.9±4.3cm. On the
other
hand, the size in 15 cases in which hernia did not occur was 3.5±2.9cm. There was a remarkable difference in their size depending on the presence or absence of hernia(p<0.05). That is, a close relation between the size of injured diaphragms and
hernia
was shown.
All diaphragmatic injuries were repaired privarily. In blunt trauma approach of repair were as follows:20(63%) thoracic, 9 abdominal, 2 thoracoabdeominal, and l thoracic and in penetrating trauma 6(50%) abdominal, 4 thoracic, and 2 thoracic and
abdominal. The complication rate was 19% in blunt trauma and 25% in penetrating trauma. Two patients with blunt trauma died with a mortalith rate of 6.3%. All patients with penetrating trauma recovered.
This study suggests that diaphragmatic injury should be suspected in all patients with blunt as well as penetrating injury of the chest and abdomen. The size of injured diaphragms was larger in blunt trauma than in penetrating trauma. For
herniation, it
appeared to be more common in blunt trauma. The morbidity and mortality were related primary to the severity of associated injuries.
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