Thoraco-abdominal injury

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Same here. We just had a patient with a traumatic diaphragmatic hernia with
a strangulated and perforated transverse colon in the left chest. Good thing
the patient made it. This was from a small stab wound in the left lower
lateral chest 2 years ago who did not undergo any exploration. In fact, all
patients with a penetrating injury in our small series did not have a
previous laparotomy.

Jose Luis J. Danguilan, MD

On Thu, Sep 17, 2009 at 7:38 PM, Miranda Voss <mvossak at yahoo.co.uk> wrote:

> We work in a 266 bed rural regional hospital (level 2 equivalent) with high
> incidence of penetrating trauma. We see at least two patients per year with
> incarcerated stomach or bowel in the chest from antecedent low left chest
> stabs. As a result, we laparoscope left sided chest stabs that are inferior
> to the scapula, even with soft abdomens. About 30% have a diaphragmatic
> injury which can be repaired laparoscopically (last internal audit 2007, we
> haven’t looked at it since then).
>
> Anecdotal, I know, but I think that diaphragm injury is a significant
> concern and would add my vote to the laparoscopy group.
>
> Miranda Voss
> Worcester Hospital
> Winelands/Overberg, South Africa.
>
>
>
>
>
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