Penetrating and blunt diaphragmatic injuries

Objective: The purpose of this study is to analyze the ruptured diaphragm retrospectively in regard to mechanism of injury, diagnosis and treatment; and to discuss the difficulties in their diagnosis. Methods: Thirty patients were included in the study and the study was carried out at Al-Yarmouk Teaching Hospital, Baghdad, Iraq, over a 9 year period (1992-2001). Their demographic data, diagnosis and treatment were recorded. Results: Twenty-one patient had civilian penetrating injuries, while 9 suffered blunt trauma. Young males were the predominant victims. Three cases of the blunt trauma group had a delayed diagnosis, (2 after repeated chest radiography and one after Ba meal). Conclusion: The preoperative diagnosis of diaphragmatic injuries is difficult. Most cases are diagnosed during exploration for associated injuries. The case is more difficult after blunt trauma. Repeated chest radiography and gastrointestinal contrast studies can be used for the diagnosis.