Controversies in the management of asymptomatic patients sustaining penetrating thoracoabdominal wounds
The most challenging diagnostic issue in the management of thoracoabdominal wounds concerns the assessment of asymptomatic patients. In almost one-third of such cases, diaphragmatic injuries are present even in the absence of any clear clinical signs. The sensitivity of noninvasive diagnostic tests...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2008-01-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000500020 |
| _version_ | 1811327311204581376 |
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| author | Jose Gustavo Parreira Samir Rasslan Edivaldo M. Utiyama |
| author_facet | Jose Gustavo Parreira Samir Rasslan Edivaldo M. Utiyama |
| author_sort | Jose Gustavo Parreira |
| collection | DOAJ |
| description | The most challenging diagnostic issue in the management of thoracoabdominal wounds concerns the assessment of asymptomatic patients. In almost one-third of such cases, diaphragmatic injuries are present even in the absence of any clear clinical signs. The sensitivity of noninvasive diagnostic tests is very low in this situation, and acceptable methods for diagnosis are limited to videolaparoscopy or videothoracoscopy. However, these procedures are performed under general anesthesia and present real, and potentially unnecessary, risks for the patient. On the other hand, diaphragmatic hernias, which can result from unsutured diaphragmatic lesions, are associated with considerable morbidity and mortality. In this paper, the management of asymptomatic patients sustaining wounds to the lower chest is discussed, with a focus on the diagnosis of diaphragmatic injuries and the necessity of suturing them. |
| first_indexed | 2024-04-13T15:05:31Z |
| format | Article |
| id | doaj.art-73c2d6f401474433b28b36f181b3e8d1 |
| institution | Directory Open Access Journal |
| issn | 1807-5932 1980-5322 |
| language | English |
| last_indexed | 2024-04-13T15:05:31Z |
| publishDate | 2008-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-73c2d6f401474433b28b36f181b3e8d12022-12-22T02:42:11ZengElsevier EspañaClinics1807-59321980-53222008-01-0163569570010.1590/S1807-59322008000500020Controversies in the management of asymptomatic patients sustaining penetrating thoracoabdominal woundsJose Gustavo ParreiraSamir RasslanEdivaldo M. UtiyamaThe most challenging diagnostic issue in the management of thoracoabdominal wounds concerns the assessment of asymptomatic patients. In almost one-third of such cases, diaphragmatic injuries are present even in the absence of any clear clinical signs. The sensitivity of noninvasive diagnostic tests is very low in this situation, and acceptable methods for diagnosis are limited to videolaparoscopy or videothoracoscopy. However, these procedures are performed under general anesthesia and present real, and potentially unnecessary, risks for the patient. On the other hand, diaphragmatic hernias, which can result from unsutured diaphragmatic lesions, are associated with considerable morbidity and mortality. In this paper, the management of asymptomatic patients sustaining wounds to the lower chest is discussed, with a focus on the diagnosis of diaphragmatic injuries and the necessity of suturing them.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000500020Diaphragmatic injuryVideolaparoscopyVideothoracoscopyThoracic traumaDiaphragmatic hernia |
| spellingShingle | Jose Gustavo Parreira Samir Rasslan Edivaldo M. Utiyama Controversies in the management of asymptomatic patients sustaining penetrating thoracoabdominal wounds Clinics Diaphragmatic injury Videolaparoscopy Videothoracoscopy Thoracic trauma Diaphragmatic hernia |
| title | Controversies in the management of asymptomatic patients sustaining penetrating thoracoabdominal wounds |
| title_full | Controversies in the management of asymptomatic patients sustaining penetrating thoracoabdominal wounds |
| title_fullStr | Controversies in the management of asymptomatic patients sustaining penetrating thoracoabdominal wounds |
| title_full_unstemmed | Controversies in the management of asymptomatic patients sustaining penetrating thoracoabdominal wounds |
| title_short | Controversies in the management of asymptomatic patients sustaining penetrating thoracoabdominal wounds |
| title_sort | controversies in the management of asymptomatic patients sustaining penetrating thoracoabdominal wounds |
| topic | Diaphragmatic injury Videolaparoscopy Videothoracoscopy Thoracic trauma Diaphragmatic hernia |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000500020 |
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