Penetrating Traumatic Diaphragm Injuries
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Panda A, Kumar A, Gamanagatti S, Patil A, Kumar S, Gupta A. Traumatic diaphragmatic injury: a review of CT signs and the difference between blunt and penetrating injury. Diagn Interv Radiol. 2014;20(2):121–8. Panda and colleagues performed a detailed and thorough review of imaging findings associated with TDI, and most importantly they compared the utility of individual diagnostic signs for blunt versus penetrating TDI in the absence of a diaphragmatic hernia. They found that although the standardly reported radiologic signs were useful for blunt injuries, they were mostly unreliable in penetrating trauma. The most reliable sign for penetrating TDI was the presence of contiguous injuries to organs on each side of the diaphragm, which was present in over 80 % of cases.
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Ozogul B, Kisaoglu A, Ozturk G, et al. Does a penetrating diaphragm injury have an effect on morbidity and mortality? Ulus Travma Acil Cerrahi Derg Turk J Trauma Emerg Surg TJTES. 2013;19(1):45–8. Ozogul et al. analyzed a series of 237 patients with penetrating trauma to the abdomen over a 15-year period. They compared the 60 patients with a diaphragm injury to 177 without TDI. Although the overall complication rates were high, there was no difference between those with a TDI (47 %) versus those without (50 %). Mortality was also similar at 7 % in the TDI group versus 10 % without a TDI. In addition to providing thorough epidemiologic descriptive data for the TDI cohort, they demonstrated that there appeared to be no added morbidity or mortality associated with the presence of a diaphragm injury.
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