PT  - JOURNAL ARTICLE
AU  - Abdel Hadi, Maha S.
AU  - Al-Mulhim, Abdulmohsen A.
AU  - Al-Awad, Naif I.
AU  - Zakaria, Hazem M.
AU  - Al-Awami, Majed S.
TI  - Diaphragmatic injury. A clinical review
DP  - 2001 Oct 01
TA  - Saudi Medical Journal
PG  - 890--894
VI  - 22
IP  - 10
4099  - http://smj.org.sa/content/22/10/890.short
4100  - http://smj.org.sa/content/22/10/890.full
SO  - Saudi Med J2001 Oct 01; 22
AB  - OBJECTIVE: Recent experience at King Fahad Hospital of the University, Al-Khobar University, Kingdom of Saudi Arabia was reviewed to identify the pitfalls in the diagnosis of diaphragmatic injuries, and attempt to develop a scheme by which early diagnosis is achieved in order to avoid the sequelae of delayed presentations.METHODS: A retrospective chart review of patients admitted to the surgical service, with the diagnosis of diaphragmatic injury was undertaken during the period June 1994 through to June 1999.RESULTS: The total number was 8 patients, and the age ranged between 6-71 years. Of these patients 5 were diagnosed immediately post-traumatic, 2 with delayed presentation, and one with recurrent post-traumatic repair. This case was excluded. Six patients presented following blunt and one after penetrating trauma. Rupture occurred mainly on the left dome of the diaphragm in 5 patients and on the right in 2. Complications ranged from mild chest symptoms to severe respiratory and multi-system involvement.CONCLUSION: Diaphragmatic injuries occurred in 2%-5% of multiple trauma victims. It is considered a predictor of serious associated injuries, However, as many as 10%-30% are missed during the initial evaluation. A high index of suspicion is required, and judicious use of diagnostic aids should be employed to reach early diagnosis to avoid the sequelae of missed injuries.