Traumatisk diafragmaruptur - en svårdiagnostiserad skada. Retrospektiv journalstudie av ett svenskt material
Engelsk titel: Traumatic diaphragmatic rupture (TDR) is a diagnostic challenge. Retrospective study of Swedish medical records
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Författare:
Alexandersson, Hanna
;
Riddez, Louis
Email: hanna.alexandersson@stud.ki.se
Språk: Swe
Antal referenser: 19
Dokumenttyp:
Artikel
UI-nummer: 14017437
Sammanfattning
Traumatic diaphragmatic rupture (TDR) is a diagnostic challenge and may result in serious complications if not treated. This retrospective study of medical records of 38 patients with TDR at a Swedish trauma center demonstrated a diagnostic sensitivity of chest X-ray of only 21%. The sensitivity of computer tomography (CT) was much better, especially when TDR was caused by blunt trauma (93%). When TDR was caused by penetrating trauma, the sensitivity of CT was only 36% and thus there is a substantial risk to miss small TDR in these patients. TDR was diagnosed during the first 24 hours in 92% which was a good result compared to previous reports. The majority of patients were treated with surgery which is the correct way of treatment, except in some rare cases. In conclusion, this study shows that TDR is clearly a diagnostic challenge and if TDR is suspected from clinical evidence after penetrating trauma, explorative surgery should be considered despite negative CT.