[Clinical and therapeutic aspects of traumatic diaphragmatic hernia]

The authors present 5 cases of diaphragmatic hernia occuring after thoracoabdominal trauma (in one case the hernia was in the right hemidiaphragm, associated with partial hepato-thorax, the other four were in the left hemidiaphragm and were associated with intra-thoracic herniation of the stomach, transverse large bowel, large epiploon, loops of the small bowel and of the spleen). In three cases the lesion was treated by the thoracic route while in the other two the abdominal route was preferred. In one of the cases splenectomy and segmental transverse colectomy were performed by the transthoracophrenic approach. This was necessary because of the length of the pedicles, as well as of the risks entailed by an eventual attempt at re-positioning the viscera.