警惕漏诊创伤性膈肌损伤中合并腹腔脏器损伤OACSTPCD

Objective To summarize the clinical characteristics and causes in patients with traumatic diaphragm inju-ry who may have missed abdominal organ injury before surgery,and to explore the necessity of abdominal exploration in such patients.Methods The clinical data of 13 patients with traumatic diaphragm injury who had missed abdominal organ injury before surgery from September 2013 to August 2023 were retrospectively analyzed.Results Among the 13 patients,there were 12 males and 1 female,with an average age of 42.5 years.Eight patients had penetrating injuries and 5 patients had blunt injuries.Thoracic exploration revealed diaphragmatic injury,followed by abdominal exploration.The results showed liver injury in 4 patients,stomach injury in 4 patients,splenic injury in 3 patients,mesentery injury in 2 patients,small intestine injury in 1 patient,inferior vena cava injury in 1 patient,and pancreas injury in 1 patient.All patients underwent diaphragm repair and abdominal organ injury was treated with operation or conservative treatment.All patients recovered and no patients died.Conclusion When diaphragm injury is found in exploratory thoracic surgery,peritoneal exploration should be per-formed actively even if the preoperative abdominal signs and imaging findings are negative,so as to timely detect possible ab-dominal organ injury,to avoid missed diagnosis and misdiagnosis,and improve the prognosis of patients.