Purpose: Although all diaphragmatic injuries caused by stab
wounds need to be repaired, preoperative diagnosis is often difficult.
The purpose of the present study is to share our experience
regarding diaphragmatic wounds.
Patients and Methods: Eighteen patients with stab wounds causing
diaphragmatic injuries treated at General Surgery Clinic of İnönü
University Faculty of Medicine between March 2000 and June 2009
were evaluated retrospectively.
Results: There were 15 male and 3 female patients with mean age
of 33 (20-69) years. Most common complaints were difficulty in
breathing, and abdominal and chest pain. Localization of the injury
was on the left side of the diaphragm in 11 (61%) patients and on the right side in 6 (33%) patients, and one (6%) patient had injuries
on both sides. Surgery was performed in 17 patients with midline
abdominal incision within the first 24 hours after the injury and with
lateral thoracotomy in a patient 10 days after injury. Mortality occurred
in 3 (17%) patients; in 2 patients due to bleeding from accompanying
injuries and in one patient due to postoperative sepsis.
Conclusion: Preoperative diagnosis of diaphragmatic injury due to
a stab wound is difficult. These patients highly probably have visceral
organ injuries in addition to diaphragmatic injuries. Diaphragmatic
injuries should be kept in mind in patients with abdominal
penetrating stab injuries which are located between umbilicus and
xiphoid. Both hemidiaphragms should be explored carefully during
abdominal surgery of these patients.