Frequency of diaphragmatic trauma in fire-arm injury of abdominal cases and outcome of its management

ABSTRACT

To determine frequency of diaphragmatic trauma in fire-arm injuries of abdomen and to determine outcome of its management. Retrospective study. This study was conducted at Department of Surgery, Unit B, Lady Reading Hospital Peshawar over a period of one year from January 2014 to January 2015. Record of all fire-arm injury cases, who presented during study period, was analyzed. Data were collected on pre-designed proforma from admitted patient record [patients charts] and operation theatre notes register. Demographic data, site and frequency of injury to diaphragm, operative findings, and outcome were the variables of study. Out of total 83 patients of fire-arm injuries, 14 [16.8%] patients had diaphragmatic trauma. Mean age of patient was 27.14 years. Male to female ratio was 4.91. Left dome of diaphragm was injured in 9 [64.28%] and right dome was involved in 4 [28.57%] of cases and in one patient [7.14%] patients central tendon of diaphragm was injured together with injury to pericardium that got expired. Diaphragmatic injury though not as common in abdominal fire-arm injury. There should be however very low threshold for suspicion in cases of fire-arm injury of abdomen, where bullet trajectory or mechanism of injury is suggestive, because missing such injury is not devoid of complications. The patient should be thoroughly examined and investigated for exclusion of diaphragmatic injury