ACUTE INJURIES OF THE DIAPHRAGM (ANALYSIS OF 35 CASES )

In this study 35 patients who were treated because of acute diaphragmatic rupture at Atatürk University, School of Medicine Department of General Surgery between 1.1.1988-31.12.1994 were analized. Diaphragmatic ruptures were due to penetrating trauma in 25 (71.4%) patients and blunt trauma in 10 (28.6%) patients. There were 11 (44%) left, 11 (44%) right and 3 (12%) bilateral diaphragmatic ruptures in blunt trauma group. Diagnostic value of PA chest x-ray was found to be 28.5. The most frequent concomitant organ traumas were spleen (42.8%), liver (40%) and stomach (31.4%). The most frequent postoperative complications related to lungs (54.3%). There were 8 (22.8%) postoperative mortalities. Diaphragmatic ruptures because of concomitant organ traumas have high morbidity and mortality rates. In diagnosis the most important step is to remember this entity. Diaphragma must be examined carefully in multysystem trauma patient.

AKUT DÝYAFRAGMA YARALANMALARI

Çalýþmamýzda Atatürk Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dalý'nda 1.1.1988-31.12.1994 tarihleri arasýnda akut diyafragma yaralanmasý nedeniyle tedavi edilen 35 olgunun analizi yapýldý. Olgularýn 257 (%71.4) penetran 10'u (%28.6) künt yaralanma þeklinde idi. Penetran yaralanmalarýn 11'i (%44) solda, 11'i (%44) saðda 3'ü bilateraldi. Künt yaralanmalarda ise 8'i (%80) solda, 2'si (%20) saðda idi. PA Akciðer grafisinin preoperatif taný deðeri %28.5 olarak bulundu. En sýk yaralanan yandaþ organlar sýrasý ile dalak (%42.8), karaciðer (%40.0) ve mide (%314) idi. En sýk görülen postoperatif komplikasyonlar akciðerlerle ilgili olanlardý (%53.4). Mortalite 8 (%22.8) olguda oluþtu. Bunlarýn tamamý diðer nedenlere baðlý idi. Akut diyafragma yaralanmalarý yandaþ organ yaralanmalarý nedeniyle morbidite ve mortalitesi yüksek olgulardýr. Tanýda en önemli konu bu olguyu hatýra getirmektir. Multisistem yaralanmalarda her iki diyafragma dikkatli bir þekilde gözden geçirilmelidir.