Traumatic ruptures of the diaphragm: evaluation of mini invasive
surgery.
GIUDICELLI R
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GROSDIDIER G
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JANCOVICI R
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HEYD B
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MANTION G
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LECUYER T
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VELLY JF
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D'JOURNO B
Seance of wednesday 16 november 2005 (pas de sujet Principal)
Abstract
Aim of the study: To determine if mini-invasive surgery can beused successfully in patients with a blunt diaphragmatic rupture.Diaphragmatic rupture occurs in about 5% of major blunt traumavictims. This complication is associated with high morbidity andmortality. Mortality is due to associated injuries. The diagnosis ofdiaphragmatic rupture remains problematic due to the poor specificityof clinical signs. Radiological study fails to show the discontinuityof the diaphragm. CT scan with axial, sagittal and coronal reformationsis systematically performed but can be equivocal in somecases. Therefore diagnosis can be missed particularly in ruptures ofthe right hemi diaphragm. Surgical treatment is performed by laparotomyor thoracotomy but mini-invasive surgery is a new approachthat may be used in a patient with a good hemodynamic situation.Results: Hospital mortality is about 16% and post-operative complicationsare essentially thoracic or abdominal sepsis.
