[Diagnosis and treatment of diaphragm traumatic ruptures]

29 patients with traumatic ruptures of left cupola of the diaphragm were studied. Pain, dispnoe, tachycardia more intensive after a meal due to repletion and dislocation of the stomach into pleural cavity and its pressure on the organs of the mediastinum were the main symptoms of the disease. The diagnosis of traumatic rupture of the diaphragm was made on the base of clinical and roentgenological examination. In the acute period of trauma the diagnosis is difficult, especially in combined trauma. In 92.3% of cases the stomach and the bowel move into the pleural cavity, which may simulate pneumothorax or relaxation of the diaphragm. Contrast examination of the gastro-intestinal tract and pleural puncture help in differential diagnosis. All the cases of traumatic ruptures of the diaphragm should be subjected to surgical treatment. Urgent operation is indicated in continuing bleeding, incarceration of organs, acute cardiopulmonary insufficiency due to the collapse of the lung and dislocation of mediastinal organs of into contralateral position. Thoracotomy in VII intercostal space is considered as a valid approach. There were 2 (6.9%) lethal outcomes after 29 operations. Long-term results are quite favourable.