BLUNT TRAUMA AND PENETRATING LESIONS OF T HE DIAPHRAGM

Between 1987 and 1992, 17 patients sustaining injury of the diaphragm were treated at our institution. All patients had associated injuries. Blunt diaphragmatic rupture (n = 13) was mostly diagnosed by chest X- ray, additional diagnostic procedures (contrast radiography, sonograph y) confirmed a suspected diaphragmatic rupture. In all 4 cases with pe netrating injury the diagnosis was found by explorative laparotomy. In 2 patients sustaining blunt diaphragm rupture the diagnosis was delay ed by 2 and 6 days. 3 patients (all sustaining blunt diaphragm rupture ) died related to their associated injuries. All patients sustaining b lunt or penetrating thoracoabdominal trauma, specially in high-velocit y road accidents and injuries by shots or knifes, are suspicious for d iaphragmatic injury.