CASE REPORT   

Chirurgia 2003 June;16(3):117-20

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: Italian

Traumatic rupture of the diaphragm: diagnostic controversies and treatment. Two case reports

Monaco F., Pavia R., Barone M., Barresi P., Mondello B., Angiò L., Versaci A., Monici D., Nunnari F., Monaco M.

Nowadays the traumatic rupture of the diaphragm still represents an extremely important diagnostic problem with therapeutic implications of significant actuality. The diagnosis is often difficult and certain complications, as visceral hernias, all but rare. The greatest incidence is statistically in the 3rd decade of life with a prevalence among male subjects (ratio 4:1) and it is generally due to blunt trauma. Costal fractures and break-up of the spleen are the most common complications. Its incidence, following blunt trauma, is between 3% and 8%, with more frequent break-ups of the left hemiphren than the counter-lateral one; car accidents turn up to be the main cause. The migration of abdominal organs into the thorax, through the diaphragmatic breach, may correspond to an evolution of the trauma, sometimes bearing serious complications; patients with diaphragmatic break-up, in fact, show later on adherences among the intrathoracic organs and those herniated abdominal. In conformity with a series of case reports appeared in the literature, it seems therefore clear how fundamentally important an early diagnosis can be.The authors report 2 uncommon cases of traumatic rupture of the diaphragm, which lead to diagnostic and therapeutic observations of significant actuality.