A COMPARISON OF RIGHT AND LEFT BLUNT TRAUMATIC DIAPHRAGMATIC RUPTURE

Since right blunt traumatic diaphragmatic rupture (BTDR) is reported w ith increasing frequency, BTDR may be a disease in evolution. Data wer e collected on 59 left, 16 right, and five bilateral BTDRs at a level I trauma center. Patients with right BTDR had lower Glasgow Coma Scale (GCS) scores (p < 0.05), were more likely to be initially in hypovole mic shock, and were admitted directly from the field (p < 0.01). Left and right BTDRs were diagnosed from chest films in 37% and 0% of cases , respectively (p < 0.05). Diagnostic peritoneal lavage results were n egative in 16% of left and 0%. of right BTDRs. For right BTDRs, the li ver was more likely to be injured (p < 0.001). The mortality rates wer e similar and ICU and hospital stays, complications, and duration of m echanical ventilation were similar for early survivors with right and left BTDRs. The clinical signs and symptoms, diagnosis, and surgical f indings associated with right and left BTDR are different.