Does a penetrating diaphragm injury have an effect on morbidity and mortality?

Background: In this study, we investigated the diaphragmatic ruptures that accompanied penetrating abdominal injury.

Methods: Records of 237 patients with penetrating abdominal trauma seen in the General Surgery Clinic between January 1996 and December 2010 were investigated retrospectively. Patients without diaphragmatic rupture were allocated to Group I and those with were allocated to Group II.

Results: Diaphragmatic injury was not present in 177 patients and present in 60 patients. Diaphragmatic injury was on the right side in 12, left side in 41, and bilateral in 7. Eleven had thoracic herniation, and the most common hernia contents were the colon, stomach, greater omentum, small bowel, and spleen. The postoperative complication rate was 50% in Group I (n=89) and 47% in Group II (n=28), and there was no significant difference between the two groups (p>0.05). The length of hospital stay was slightly increased in Group II, but not significant (p>0.05). Seventeen patients (9.6%) in Group I and four patients (6.6%) in Group II died. The difference in mortality rates between the two groups was not significant (p>0.05).

Conclusion: Diaphragmatic rupture is not common among patients with penetrating abdominal trauma. There was no difference between patients with penetrating injuries and with versus without diaphragmatic injuries in terms of mortality and morbidity.