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LAPAROSCOPY IN THE MANAGEMENT OF DIAPHRAGMATIC RUPTURE DUE TO BLUNT TRAUMA
Author(s) -
Martin Ian,
O'Rourke Nicholas,
Gotley David,
Smithers Mark
Publication year - 1998
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1998.tb02105.x
Subject(s) - medicine , laparoscopy , diaphragmatic rupture , diaphragmatic breathing , laparotomy , diaphragm (acoustics) , thoracoscopy , surgery , blunt , presentation (obstetrics) , open surgery , blunt trauma , general surgery , physics , alternative medicine , pathology , acoustics , loudspeaker
Background : Traumatic diaphragmatic rupture remains diagnostic challenge often unrecognized until laparotomy in over 40% of patients and the diagnosis is delayed in further 15%. This report describes four patients diagnosed at laparoscopy with ruptured diaphragm. Methods : One patient had left diaphragmatic rupture amenable to laparoscopic repair in the emergency setting. Three patients underwent laparoscopy 2, 7 and 10 days after injury which revealed two right‐sided and one extensive left‐sided rupture, respectively; each required open repair. Results : While laparoscopy is an excellent diagnostic tool, particularly in the delayed setting, repair is not possible for right‐sided ruptures because of the liver bulk. Conclusions : Thoracoscopy in the instance of delayed presentation may offer the best chance for minimal‐access diagnosis and treatment when there is suspicion of right‐sided diaphragmatic rupture.