Diagnosis, treatment, and management of traumatic diaphragmatic rupture: A multi-center study

Sep 29, 2026

Background: Traumatic diaphragmatic rupture requires timely evaluation to optimize surgical outcomes and patient prognosis, and diagnostic technology has evolved in recent years. Methods: From January 2014 to January 2024, 35 patients undergoing diaphragmatic repair in three centers were retrospectively analyzed, including preoperative diagnosis, trauma characteristics, imaging, intraoperative diagnosis, associated injuries, procedures, complications, and hospital stay. Results: Penetrating trauma dominated; morbidity was 40% with 5.7% mortality. Longer stays occurred in the laparotomy group. Conclusion: Early recognition and prompt management are essential, with surgical procedure selection guided by concomitant injuries.

LanguageEnglish

CategoryHealthcare

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Turkish Journal of Thoracic and Cardiovascular Surgery 2025;33(4):517-527 Orıgınal Artıcle / Özgün Makale Diagnosis, treatment, and management of traumatic diaphragmatic rupture: A multi-center study Travmatik diyafram rüptürünün tanısı, tedavisi ve yönetimi: Çok merkezli çalışma Omer Topaloglu1􀀬, Kubra Nur Kılıc2􀀬, Sami Karapolat2􀀬, Kerim Tuluce1􀀬, Buket Kaytaz Alkas2􀀬, Atila Turkyilmaz2􀀬, Banu Karapolat3􀀬, Aziz Gumus4􀀬, Hasan Turut1􀀬, Celal Tekinbas2􀀬 Institution where the research was done: Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye Author Affiliations: 1Department of Thoracic Surgery, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Türkiye 2Department of Thoracic Surgery, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye 3Department of General Surgery, University of Health Sciences Trabzon Faculty of Medicine, Trabzon, Türkiye 4Department of Pulmonology, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Türkiye ABSTRACT Background: This study aims to evaluate the diagnosis, surgical outcomes, and prognosis of patients with traumatic diaphragmatic rupture and discuss recent advancements in diagnostic technologies. Methods: Between January 2014 and January 2024, a total of 35 patients (27 males, 8 females; mean age: 45.3±14.2 years; range, 13 to 68 years) who underwent diaphragmatic repair for traumatic diaphragmatic rupture in three centers were retrospectively analyzed. Data including demographic characteristics of the patients, medical history, type of trauma, clinical findings, diagnostic methods used preoperatively, preoperative interventions, the establishment of an intraoperative diagnosis, associated organ injuries, side of the diaphragmatic rupture, type of surgical procedure, postoperative complications, and length of hospital stay were recorded. Results: Among the cases, penetrating trauma was the most common mechanism (62.9%) . Among the 25 patients who underwent computed tomography, a preoperative diagnosis of diaphragmatic rupture was established in 14 (56%) . The median defect size in the diaphragm was 5.7 cm in blunt trauma cases and 4.04 cm in penetrating trauma cases. The morbidity rate was 40%, and the mortality rate was 5.7% . The length of hospital stays for the surgically treated patients ranged from 4 to 16 days. Comparing the laparotomy and thoracotomy groups, the laparotomy group had a longer hospital stay (p=0.017) and had statistically significant data in terms of participation in multidisciplinary surgery (p=0.001) . Conclusion: Diaphragmatic rupture should be considered in cases involving high-energy blunt trauma, particularly when multiple lower rib fractures, liver lacerations, or splenic lacerations are present, or inpatients with a history of penetrating trauma to the thoracoabdominal region. As delays in diagnosis and treatment may increase morbidity and mortality, early recognition and prompt management are essential. The choice of surgical procedure should be guided by the presence or absence of concomitant injuries. Keywords: Multidisciplinary, radiological imaging, surgery, traumatic diaphragmatic rupture. ÖZ Amaç: Bu çalışmada, travmatik diyafram rüptürü olan hastaların tanısı, cerrahi sonuçları ve prognozu değerlendirildi ve tanı teknolojilerindeki son gelişmeler irdelendi. Çalışma planı: Ocak 2014 - Ocak 2024 tarihleri arasında üç farklı merkezde travmatik diyafram rüptürü nedeniyle ameliyat edilen toplam 35 hasta (27 erkek, 8 kadın; ort. yaş: 45.3±14.2 yıl; dağılım, 13-68 yıl) retrospektif olarak incelendi. Hastaların demografik özellikleri, tıbbi öyküsü, travma türü, klinik bulguları, ameliyat öncesi kullanılan tanı yöntemleri, ameliyat öncesi girişimler, ameliyat sırası konulan tanı, ilişkili organ hasarları, diyafram rüptürünün yeri, cerrahi işlem türü, ameliyat sonrası komplikasyonlar ve hastanede kalış süresi dahil olmak üzereveriler kaydedildi. Bulgular: Olgular arasında penet

FAQs

What was the main purpose of the study on traumatic diaphragmatic rupture?

To evaluate diagnosis, surgical outcomes, and prognosis in patients with traumatic diaphragmatic rupture and to discuss recent advancements in diagnostic technologies.

How was the study conducted and what patient data were collected?

A retrospective analysis included 35 surgically treated patients from three centers (Jan 2014–Jan 2024), collecting demographics, trauma details, preoperative diagnostic methods, intraoperative diagnosis, associated organ injuries, procedure type, complications, and hospital stay.

What were the key findings regarding imaging diagnosis and outcomes?

Among patients who underwent computed tomography, preoperative diagnosis was established in 56% of cases. Penetrating trauma was most common, with morbidity 40% and mortality 5.7%, and hospital stay ranged from 4 to 16 days for surgically treated patients.

Sep 29, 2026

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