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Abstract
The aim of this study was to determine the relationship between diaphragmatic injury
and gross contamination of the peritoneal cavity caused by gastric injuries and the
occurrence of postoperative complications, especially those related to the pleural
cavity. Charts of 73 patients sustaining gastric injuries due to penetrating trauma
were retrospectively reviewed. There were 66 males and mean age was 28 years. Stab
wounds were the most frequent mechanism of injury, occurring in 46 cases. Most of
the injuries were treated using simple suture and minor debridement. Postoperative
morbidity rate was 30 per cent and thoracic complications occurred in 11 patients.
Twenty-six patients had diaphragmatic injuries; 54 per cent of them developed postoperative
complications. Of the remaining 47 patients without diaphragmatic injuries, only eight
developed complications. Of the 26 patients with diaphragmatic injuries, seven developed
pleuropulmonary complications compared with 4 of 47 without diaphragmatic injury.
Of sixteen patients who had gross contamination secondary to gastric injury, characterized
by the presence of food or great amounts of gastric contents in the peritoneal cavity,
10 developed postoperative complications compared with 12 of 57 without gross contamination.
Overall mortality rate was 11 per cent mostly due to sepsis. In conclusion, the presence
of a diaphragmatic injury as well as gross contamination of the abdominal cavity are
important factors related to the development of postoperative infections particularly
in the pleural space.
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Article info
Publication history
Accepted:
April 19,
1995
Identification
Copyright
© 1995 Published by Elsevier Inc.
