Diaphragm Injury
- Laparoscopy is sufficient to exclude occult diaphragm injury after penetrating abdominal trauma.
- Friese RS, Coln CE, Gentilello LM.
- J Trauma. 2005 Apr;58(4):789-92.
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Rationale for inclusion: This study confirms the utility of laparoscopy to exclude diaphragmatic injury in patients sustaining penetrating thoracoabdominal injury with high specificity and sensitivity.
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- Traumatic rupture of the diaphragm: experience with 65 patients.
- Mihos P, Potaris K, Gakidis J, Paraskevopoulos J, Varvatsoulis P, Gougoutas B, Papadakis G, Lapidakis E.
- Injury. 2003 Mar;34(3):169-72.
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Rationale for inclusion: This descriptive experience of 65 patients advocates for thorough examination of both hemidiaphragms at exploration for timely identification of these injuries, which are associated with multiple additional traumatic injuries in the majority of cases.
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- Helical CT of diaphragmatic rupture caused by blunt trauma.
- Killeen KL, Mirvis SE, Shanmuganathan K.
- AJR Am J Roentgenol. 1999 Dec;173(6):1611-6.
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Rationale for inclusion: This study of 41 patients with diaphragm injury concluded the sensitivity of helical CT to detect left and right sided diaphragm in juries is 78% and 50%, respectively.
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- Occult injuries to the diaphragm: prospective evaluation of laparoscopy in penetrating injuries to the left lower chest.
- Murray JA, Demetriades D, Asensio JA, Cornwell EE 3rd, Velmahos GC, Belzberg H, Berne TV.
- J Am Coll Surg. 1998 Dec;187(6):626-30.
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Rationale for inclusion: Using 110 patients with penetrating injuries to the left lower chest, this study found a high incidence of occult diaphragm injuries (24%), siting the utility of laparoscopy in the identification of these injuries. '
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- Traumatic diaphragmatic hernia. Occult marker of serious injury.
- Meyers BF, McCabe CJ.
- Ann Surg. 1993 Dec;218(6):783-90.
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Rationale for inclusion: This single center case series of 68 patients recognized the morbidity and mortality associated with the high prevalence of additional injuries that accompany traumatic diaphragm injury, recommending aggressive evaluation.
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- A critical evaluation of laparoscopy in penetrating abdominal trauma.
- Ivatury RR, Simon RJ, Stahl WM.
- J Trauma. 1993 Jun;34(6):822-7; discussion 827-8.
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Rationale for inclusion: While limited in its utility for diagnosis of hollow viscus injury, this series of 100 patients with penetrating abdominal injuries identified diaphragm injuries with excellent accuracy.
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- Diaphragmatic rupture due to blunt trauma: sensitivity of plain chest radiographs.
- Gelman R, Mirvis SE, Gens D.
- AJR Am J Roentgenol. 1991 Jan;156(1):51-7.
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Rationale for inclusion: This study retrospectively reviewed the chest radiography of 50 patients with blunt hemidiaphragm rupture and found that films were diagnostic in 46% of patients on admission with an additional subset of injuries identified on delayed imaging.
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