Background: Traumatic ruptures of the diaphragm (TRD) are serious lesions that are often part of polytrauma. They pose a real diagnostic and therapeutic challenge in a disadvantaged environment such as ours. Methods: ...Background: Traumatic ruptures of the diaphragm (TRD) are serious lesions that are often part of polytrauma. They pose a real diagnostic and therapeutic challenge in a disadvantaged environment such as ours. Methods: We conducted a descriptive observational study covering a period of 11 years in 3 referral hospitals in the city of Yaoundé (Cameroon). All patients who had undergone surgery for a traumatic rupture of the diaphragm between January 1, 2011 and December 31, 2020, and whose outcome within 30 days of surgery was known were included. Results: A total of 27 patients were collected. Their mean age was 36.4 ± 19.7 years. There was a strong male predominance with 22 cases (81.5%). The TRD occurred mainly after an assault (n = 9, 33.3%), was mainly on the left side (n = 25, 92.6%) and was most often part of a polytrauma (n = 17, 62.9%). The lesions associated with TRD were mainly visceral (n = 11) and bony (n = 6). The diagnosis was made preoperatively in only 13 patients (48.1%). The average length of the diaphragmatic breach was 6.4 ± 4.5 cm and a simple suture was most often used for the repair (26 cases or 96.3%). Four osteosynthesis procedures were performed at the same time as the diaphragmatic repair. The morbidity rate was 51.9%, with surgical site infection as the main complication. Six deaths (22.2%) were recorded;septic shock was the main etiology (n = 4). Conclusion: The hospital incidence of TRD remains low in our context. These lesions remain associated with significant morbidity and mortality and require a multidisciplinary approach.展开更多
Shock tubes are devices in which the state of a gas is changed suddenly from one uniform state to another by the passage of shock and expansion waves.In the theory of ideal shock tube flow,it is customarily assumed th...Shock tubes are devices in which the state of a gas is changed suddenly from one uniform state to another by the passage of shock and expansion waves.In the theory of ideal shock tube flow,it is customarily assumed that the unsteady expansion and shock waves generated by diaphragm rupture are a perfectly centered plane wave.However, such waves are generally not centered,or may not even by plane in practice.In the present research,the time-dependent behavior of homogeneous and heterogeneous condensation of moist air in the shock tube is investigated by using a computational fluid dynamics work.Further,the numerical and experimental studies were carried out in order to investigate the effect of the diaphragm rupture process on the flow characteristics of expansion and shock waves generated near the diaphragm.展开更多
文摘Background: Traumatic ruptures of the diaphragm (TRD) are serious lesions that are often part of polytrauma. They pose a real diagnostic and therapeutic challenge in a disadvantaged environment such as ours. Methods: We conducted a descriptive observational study covering a period of 11 years in 3 referral hospitals in the city of Yaoundé (Cameroon). All patients who had undergone surgery for a traumatic rupture of the diaphragm between January 1, 2011 and December 31, 2020, and whose outcome within 30 days of surgery was known were included. Results: A total of 27 patients were collected. Their mean age was 36.4 ± 19.7 years. There was a strong male predominance with 22 cases (81.5%). The TRD occurred mainly after an assault (n = 9, 33.3%), was mainly on the left side (n = 25, 92.6%) and was most often part of a polytrauma (n = 17, 62.9%). The lesions associated with TRD were mainly visceral (n = 11) and bony (n = 6). The diagnosis was made preoperatively in only 13 patients (48.1%). The average length of the diaphragmatic breach was 6.4 ± 4.5 cm and a simple suture was most often used for the repair (26 cases or 96.3%). Four osteosynthesis procedures were performed at the same time as the diaphragmatic repair. The morbidity rate was 51.9%, with surgical site infection as the main complication. Six deaths (22.2%) were recorded;septic shock was the main etiology (n = 4). Conclusion: The hospital incidence of TRD remains low in our context. These lesions remain associated with significant morbidity and mortality and require a multidisciplinary approach.
文摘Shock tubes are devices in which the state of a gas is changed suddenly from one uniform state to another by the passage of shock and expansion waves.In the theory of ideal shock tube flow,it is customarily assumed that the unsteady expansion and shock waves generated by diaphragm rupture are a perfectly centered plane wave.However, such waves are generally not centered,or may not even by plane in practice.In the present research,the time-dependent behavior of homogeneous and heterogeneous condensation of moist air in the shock tube is investigated by using a computational fluid dynamics work.Further,the numerical and experimental studies were carried out in order to investigate the effect of the diaphragm rupture process on the flow characteristics of expansion and shock waves generated near the diaphragm.
