Diaphragmatic Injuries in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission

Introduction: Penetrating thoracoabdominal injuries (PTAIs) are associated with diaphragmatic injuries and subsequent complications. This study aimed to describe the prevalence of diaphragmatic injuries in patients with PTAI without signs of shock or acute abdomen at admission. Methods: A cross-sect...

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Main Authors: Alejandro González-Muñoz, Laura Otálora González, María Paula Fontecha Pinzón, Angela Cristina Ríos Cadavid, Cristina Judith Padilla Herrera, Danny Michell Conde Monroy, José Gabriel Rodríguez-Narváez, David Rene Rodriguez Lima
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Journal of Emergencies, Trauma and Shock
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Online Access:https://journals.lww.com/10.4103/jets.jets_33_24
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author Alejandro González-Muñoz
Laura Otálora González
María Paula Fontecha Pinzón
Angela Cristina Ríos Cadavid
Cristina Judith Padilla Herrera
Danny Michell Conde Monroy
José Gabriel Rodríguez-Narváez
David Rene Rodriguez Lima
author_facet Alejandro González-Muñoz
Laura Otálora González
María Paula Fontecha Pinzón
Angela Cristina Ríos Cadavid
Cristina Judith Padilla Herrera
Danny Michell Conde Monroy
José Gabriel Rodríguez-Narváez
David Rene Rodriguez Lima
author_sort Alejandro González-Muñoz
collection DOAJ
description Introduction: Penetrating thoracoabdominal injuries (PTAIs) are associated with diaphragmatic injuries and subsequent complications. This study aimed to describe the prevalence of diaphragmatic injuries in patients with PTAI without signs of shock or acute abdomen at admission. Methods: A cross-sectional, single-centered study was conducted in Bogotá, Colombia. The study included all patients with PTAI who underwent surgical exploration and were admitted without signs of shock or acute abdomen, between January 2019 and August 2021. Indications for surgical exploration included presence of left thoracoabdominal wound, hemo- or pneumothorax in presurgical imaging, abdominal pain, hypotension, or anemia. Results: A total of 284 patients were included in the final analysis. The median age was 29 years (interquartile range: 22–33), with 269 (94.7%) patients being males. Out of these, 268 (94.3%) patients experienced stabbing as the mechanism of injury. The prevalence of diaphragmatic injuries diagnosed during surgical exploration was 15.1% (43 patients). There were 183 patients with left-sided PTAI and 115 patients with right-sided PTAI. The prevalence of the right diaphragmatic injury was 25.2% (29 patients), while for left diaphragmatic injury, it was 8.1% (15 patients). Only one patient presented with bilateral diaphragmatic injury. Conclusions: The prevalence of diaphragmatic injuries in patients with PTAI, without signs of shock or acute abdomen upon admission, was 15.1%. However, the prevalence was 25.2% in the right PTAI and 8.1% in the left PTAI. These findings suggest that surgical exploration of the diaphragm in cases of PTAI should be performed regardless of the side of the wound.
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spelling doaj-art-24d658462a85401cbb1f66ebcf3b98512025-01-07T06:57:17ZengWolters Kluwer Medknow PublicationsJournal of Emergencies, Trauma and Shock0974-27000974-519X2024-12-0117422523010.4103/jets.jets_33_24Diaphragmatic Injuries in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at AdmissionAlejandro González-MuñozLaura Otálora GonzálezMaría Paula Fontecha PinzónAngela Cristina Ríos CadavidCristina Judith Padilla HerreraDanny Michell Conde MonroyJosé Gabriel Rodríguez-NarváezDavid Rene Rodriguez LimaIntroduction: Penetrating thoracoabdominal injuries (PTAIs) are associated with diaphragmatic injuries and subsequent complications. This study aimed to describe the prevalence of diaphragmatic injuries in patients with PTAI without signs of shock or acute abdomen at admission. Methods: A cross-sectional, single-centered study was conducted in Bogotá, Colombia. The study included all patients with PTAI who underwent surgical exploration and were admitted without signs of shock or acute abdomen, between January 2019 and August 2021. Indications for surgical exploration included presence of left thoracoabdominal wound, hemo- or pneumothorax in presurgical imaging, abdominal pain, hypotension, or anemia. Results: A total of 284 patients were included in the final analysis. The median age was 29 years (interquartile range: 22–33), with 269 (94.7%) patients being males. Out of these, 268 (94.3%) patients experienced stabbing as the mechanism of injury. The prevalence of diaphragmatic injuries diagnosed during surgical exploration was 15.1% (43 patients). There were 183 patients with left-sided PTAI and 115 patients with right-sided PTAI. The prevalence of the right diaphragmatic injury was 25.2% (29 patients), while for left diaphragmatic injury, it was 8.1% (15 patients). Only one patient presented with bilateral diaphragmatic injury. Conclusions: The prevalence of diaphragmatic injuries in patients with PTAI, without signs of shock or acute abdomen upon admission, was 15.1%. However, the prevalence was 25.2% in the right PTAI and 8.1% in the left PTAI. These findings suggest that surgical exploration of the diaphragm in cases of PTAI should be performed regardless of the side of the wound.https://journals.lww.com/10.4103/jets.jets_33_24diaphragmaticthoracoabdominal injurytraumatic
spellingShingle Alejandro González-Muñoz
Laura Otálora González
María Paula Fontecha Pinzón
Angela Cristina Ríos Cadavid
Cristina Judith Padilla Herrera
Danny Michell Conde Monroy
José Gabriel Rodríguez-Narváez
David Rene Rodriguez Lima
Diaphragmatic Injuries in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission
Journal of Emergencies, Trauma and Shock
diaphragmatic
thoracoabdominal injury
traumatic
title Diaphragmatic Injuries in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission
title_full Diaphragmatic Injuries in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission
title_fullStr Diaphragmatic Injuries in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission
title_full_unstemmed Diaphragmatic Injuries in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission
title_short Diaphragmatic Injuries in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission
title_sort diaphragmatic injuries in patients with penetrating thoracoabdominal injuries without shock or acute abdomen at admission
topic diaphragmatic
thoracoabdominal injury
traumatic
url https://journals.lww.com/10.4103/jets.jets_33_24
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