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Diaphragmatic Injury in Patients with Penetrating Thoracoabdominal Injuries without Shock or Acute Abdomen at Admission. A cross sectional study
Título de la revista
Autores
Rodriguez Narvaez, Jose Gabriel
Fecha
2024-08-01
Directores
Rodriguez Lima, David Rene
Rios Cadavid, Angela Cristina
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Editor
Universidad del Rosario
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Resumen
Se realizó un estudio transversal, unicéntrico, en Bogotá, Colombia. El estudio incluyó a todos los pacientes con IATP sometidos a exploración quirúrgica y que ingresaron sin signos de shock o abdomen agudo, entre enero de 2019 y agosto de 2021. Las indicaciones para la exploración quirúrgica incluyeron: presencia de herida toracoabdominal izquierda, hemo o neumotórax en las imágenes prequirúrgicas, dolor abdominal, hipotensión o anemia.
Abstract
Penetrating Thoracoabdominal Injuries (PTAI) are associated with diaphragmatic injuries and subsequent complications. This study aimed to describe the prevalence of diaphragmatic injuries in patients with PTAI without signs of shock or acute abdomen at admission. Materials and Methods A cross-sectional, single-centered study was conducted in Bogotá, Colombia. The study included all patients with PTAI who underwent surgical exploration and were admitted without signs of shock or acute abdomen, between January 2019 and August 2021. Indications for surgical exploration included: presence of left thoracoabdominal wound, hemo or pneumothorax in pre-surgical imaging, abdominal pain, hypotension or anemia. Results A total of 284 patients were included in the final analysis. The median age was 29 years [IQR 22-33], with 269 patients (94.7%) being males. Out of these, 268 (94.3%) patients experienced stabbing as the mechanism of injury. The prevalence of diaphragmatic injuries diagnosed during surgical exploration was 15.1% (43 patients). There were 183 patients with left-side PTAI and 115 patients with right-side PTAI. The prevalence of right diaphragmatic injury was 25.2% (29 patients), while for left diaphragmatic injury it was 8.1% (15 patients). Only 1 patient presented with bilateral diaphragmatic injury. Conclusions The prevalence of diaphragmatic injuries in patients with PTAI, without signs of shock or acute abdomen upon admission, was 15.1%. However, the prevalence was 25.2% in right PTAI and 8.1% in left PTAI. These findings suggest that surgical exploration of the diaphragm in cases of PTAI should be performed regardless of the side of the wound.
Palabras clave
Diafragma , Exploración quirúrgica , Dolor abdominal , Hipotensión , Anemia
Keywords
Diaphragmatic , Traumatic , IATP (Abdominal Thoraco-Pelvic Injury) , Cross-sectional study Unicentric
