Diaphragmatic rupture: Is management with biological mesh feasible?

International Journal of Surgery Case Reports
Omar Al-NouriThomas Esposito

Abstract

Blunt diaphragmatic rupture is a rare event that may occur after traumatic injury. Due to its rarity and difficulty in diagnosing, delayed detection of diaphragmatic injuries can occur. Management involves repair of the diaphragmatic defect via trans-thoracic and/or trans-abdominal approaches. Most small repairs may be repaired primarily, larger defects have been historically repaired with mesh. We report a case series of five patients with diaphragmatic injuries all repaired with biologic mesh via both trans-thoracic and trans-abdominal approaches. Delayed presentation is the single most important contributor to increased morbidity and mortality in patients with blunt diaphragmatic rupture. Our case series corroborates other findings that patients with blunt diaphragmatic ruptures are at high risk for infection and thus may be repaired with use of biologic mesh versus the traditional use of synthetic mesh. This can be done without high rates of recurrence or complications from use of biologic mesh. In our series, we successfully repaired 5 diaphragmatic defects with the use of biologic mesh. With follow-up as much as 4 years out, none of our patients have had an infectious complication with the use biologic mesh and there is n...Continue Reading

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Citations

Mar 26, 2014·The Journal of Trauma and Acute Care Surgery·Jill S TiesThomas H Cogbill
May 11, 2015·The Journal of Thoracic and Cardiovascular Surgery·William C ChapmanC Francisco Espinel
Oct 19, 2016·International Journal of Surgery Case Reports·Metin ErcanMusa Akoğlu
Nov 6, 2015·Frontiers in Surgery·Stavros A AntoniouFerdinand Köckerling
Oct 11, 2017·Annals of Hepato-biliary-pancreatic Surgery·Francesco EspositoDaniel Azoulay
Jun 3, 2021·Journal of Clinical Medicine·Pietro BertoglioPiergiorgio Solli
Jul 29, 2019·International Journal of Surgery Case Reports·Dario IadicolaAntonino Mirabella

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