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KMID : 0376419780020000131
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Chonbuk University Medical Journal
1978 Volume.2 No. 0 p.131 ~ p.136
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A Clinical Evaluation of Traumatic Diaphragmatic Injuries.
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Abstract
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This report is a clinical evaluation of the diaphragmatic injuries of 17 cases seen at the Jeonbug and Jeonnam University Hospital from 1968 to Aug. 1977.
Traumatic injuries of the diaphragm were the result of direct injuries to it by the stab or bullet in 13 patients and crushing injuries in 4 patients.
There were 16 men and one woman, with age range from 3 to 51 years and the twenties was the most of all age groups.
Left side was involved more than right and the ratio was 14 to 3.
Diaphragmatic injuries might have associated organ injuries; Lung injuries occurred in 10 patients, stomach in 6 patients, spleen and liver in 4 patients.
There were herniations of the great omentum in 9 patients in penetrating injuries, and liver in 2 patients, small intestine, colon, stomach and ornentum in one patient in nonpenetrat-irig injuries.
When displacement of the viscera into the chest occurred immediately after trauma, diagnosis was not.difficult. The presence of viscera filled with gas and fluid intrathoracically and pneumothorax with peritoneal free air indicated the diagnosis.
to uncharacteristic cases or in case of minor diaphragmatic lesion without primary herniation, it was important to recognize clinical signs and X-ray findings that indicated the diagnosis and to perform the palpation-and the inspection of the diaphragm.
Characteristic X-ray findings were present in 3 of 17 cases. Direct palpation and inspection of the diaphragq were done on another 3 patients and might have contributed to the correct diagnosis before operation.
Thoracic approach was made in 12 patients and thoracoabdominal approach in 5 patients.
0ne patient who sustained multiple stab wounds and had rupture of spleen, stomach and diaphragm expired due to acute renal failure 48 hours after operation
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