Mild Left Diaphragmatic Injuries in the Thoracoabdominal Penetrating Traumas: Diagnostic Efficacy of Computed Tomography vs. Laparoscopy

¹Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran

²Fellowship Resident of Vascular Surgery, Department of General Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

³Department of General Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

⁴Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran

*Corresponding author: Esmaeilian Saeid, Department of Radiology, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran. Tel: +989120463698 E-mail: [email protected]

Received: January 07, 2022
Published: January 17, 2023

Citation: Esmaeilian S, et al. (2023). Mild Left Diaphragmatic Injuries in the Thoracoabdominal Penetrating Traumas: Diagnostic Efficacy of Computed Tomography vs. Laparoscopy. Surgeries. 4(1):10.

Copyright: Esmaeilian S, et al. © (2023)

ABSTRACT

Background: Penetrating Diaphragmatic trauma injuries were low frequent and important thoracoabdominal injuries. Among stable mild injuries, there was controversy in their management. This study was designed to investigate the diagnostic efficacy of computed tomography (CT) for the detection of diaphragmatic injury in cases undergoing diagnostic and therapeutic laparoscopic surgery in the left thoracoabdominal penetrating injuries. Methods: The study was a retrospective cross-sectional study. Thirtyone stable normal imaging patients with penetrating thoracoabdominal injury between January 2021 to January 2022 referred to Shiraz Trauma center were included. CT scan images and laparoscopic surgery results were reviewed. Two trained, blinded Radiologists reviewed the Patient’s images separately. All findings were entered into a predesigned checklist. Results: 31 male patients with a mean age of 30.58 ± 14.43 years were admitted to the ICU. The mean ISS was 10.71 ± 4.32. The chest tube was inserted for 23 (74.1%), and the mortality rate was zero. Only 6(19.4%) patients had positive laparoscopic 17 patients had positive CT scans. curled sign was the most finding16(51.61%), Band sign 3(10%), collar signs1(3.2%) and dangling sign 1(3.2%) only one %patient showed a positive collar sign. And only one dangling sign; in addition, the band sign 3 (10%) of the patients. All of them were associated with the curled sign. Conclusions: CT scans among Mild left penetrating Diaphragm Injuries patients had Sensitivity of 85.7% and specificity of 56.00%. Moreover, Curled diaphragm sign was the most frequent Indirect Finding.

Keywords: Diaphragmatic injury, thoracoabdominal penetrating traumas, computed tomography, Laparoscopy