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Laparoscopic approach to the management of penetrating traumatic diaphragmatic injury

BACKGROUND: Traditionally, laparotomy/thoracotomy is the standard approach for thoracoabdominal injuries. However, it has a non-therapeutic rate of 12–40% and 40% morbidity. Laparoscopy, as a diagnostic and therapeutic modality, has evolved to be integral to general and subspecialty surgeons in the...

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Autores principales: Tserng, Teo Li, Gatmaitan, Maria Benita
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887061/
https://www.ncbi.nlm.nih.gov/pubmed/29644264
http://dx.doi.org/10.1016/j.tcr.2017.05.010
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author Tserng, Teo Li
Gatmaitan, Maria Benita
author_facet Tserng, Teo Li
Gatmaitan, Maria Benita
author_sort Tserng, Teo Li
collection PubMed
description BACKGROUND: Traditionally, laparotomy/thoracotomy is the standard approach for thoracoabdominal injuries. However, it has a non-therapeutic rate of 12–40% and 40% morbidity. Laparoscopy, as a diagnostic and therapeutic modality, has evolved to be integral to general and subspecialty surgeons in the management of patients. However, its use in the field of trauma surgery has been limited. We present a case of traumatic diaphragmatic injury from a low velocity penetrating wound successfully repaired through laparoscopic approach. CASE PRESENTATION: A 20 year old male, presented with a traumatic diaphragmatic injury secondary to a low velocity penetrating injury. A computed tomographic scan revealed a tear on the left diaphragm with the superior pole of the spleen and omentum eviscerating through. He subsequently underwent diagnostic laparoscopy and primary repair of the diaphragmatic injury. His recovery was uneventful and he was discharged on the third postoperative day. CONCLUSION: A review of current literature and our case suggest that the use of laparoscopy for the management of penetrating thoracoabdominal injuries is continually evolving and has shown to be a promising approach compared to traditional laparotomy in carefully selected patients. Laparoscopic repair of penetrating traumatic diaphragmatic injuries is a safe and expedient option for hemodynamically stable patients.
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spelling pubmed-58870612018-04-11 Laparoscopic approach to the management of penetrating traumatic diaphragmatic injury Tserng, Teo Li Gatmaitan, Maria Benita Trauma Case Rep Article BACKGROUND: Traditionally, laparotomy/thoracotomy is the standard approach for thoracoabdominal injuries. However, it has a non-therapeutic rate of 12–40% and 40% morbidity. Laparoscopy, as a diagnostic and therapeutic modality, has evolved to be integral to general and subspecialty surgeons in the management of patients. However, its use in the field of trauma surgery has been limited. We present a case of traumatic diaphragmatic injury from a low velocity penetrating wound successfully repaired through laparoscopic approach. CASE PRESENTATION: A 20 year old male, presented with a traumatic diaphragmatic injury secondary to a low velocity penetrating injury. A computed tomographic scan revealed a tear on the left diaphragm with the superior pole of the spleen and omentum eviscerating through. He subsequently underwent diagnostic laparoscopy and primary repair of the diaphragmatic injury. His recovery was uneventful and he was discharged on the third postoperative day. CONCLUSION: A review of current literature and our case suggest that the use of laparoscopy for the management of penetrating thoracoabdominal injuries is continually evolving and has shown to be a promising approach compared to traditional laparotomy in carefully selected patients. Laparoscopic repair of penetrating traumatic diaphragmatic injuries is a safe and expedient option for hemodynamically stable patients. Elsevier 2017-08-05 /pmc/articles/PMC5887061/ /pubmed/29644264 http://dx.doi.org/10.1016/j.tcr.2017.05.010 Text en © 2017 Published by Elsevier Ltd. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Tserng, Teo Li
Gatmaitan, Maria Benita
Laparoscopic approach to the management of penetrating traumatic diaphragmatic injury
title Laparoscopic approach to the management of penetrating traumatic diaphragmatic injury
title_full Laparoscopic approach to the management of penetrating traumatic diaphragmatic injury
title_fullStr Laparoscopic approach to the management of penetrating traumatic diaphragmatic injury
title_full_unstemmed Laparoscopic approach to the management of penetrating traumatic diaphragmatic injury
title_short Laparoscopic approach to the management of penetrating traumatic diaphragmatic injury
title_sort laparoscopic approach to the management of penetrating traumatic diaphragmatic injury
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887061/
https://www.ncbi.nlm.nih.gov/pubmed/29644264
http://dx.doi.org/10.1016/j.tcr.2017.05.010
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