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Delayed traumatic diaphragmatic hernias presenting with strangulation.

O Alimoglu1, R Eryilmaz, M Sahin

  • 1First Department of Surgery, Vakif Gureba Training Hospital, Istanbul, Turkey. oalimoglu@yahoo.com

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|April 21, 2004
PubMed
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Delayed diagnosis of traumatic diaphragmatic injuries can lead to strangulation. Early suspicion and evaluation are crucial for managing these missed diaphragmatic hernias.

Area of Science:

  • Trauma Surgery
  • Surgical Diagnostics
  • Abdominal Imaging

Background:

  • Traumatic diaphragmatic injuries (TDIs) often result from blunt or penetrating trauma.
  • Missed TDIs can lead to delayed presentation as chronic diaphragmatic hernias, potentially causing strangulation.
  • This study focuses on three cases of delayed traumatic diaphragmatic hernias with strangulation.

Observation:

  • All three patients presented with strangulation due to missed diaphragmatic injuries.
  • The trauma mechanisms included blunt (two cases) and penetrating (one case).
  • Diagnoses were missed in both acute and chronic settings for all patients.

Findings:

  • Two patients experienced transverse colonic strangulation, while one had stomach and spleen strangulation.

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  • One patient required transverse colon resection.
  • Two patients had postoperative complications; however, no mortality was observed.

    • Implications:

    • Patients with upper abdominal pain and dyspnea post-trauma require evaluation for missed diaphragmatic injury.
    • A high index of suspicion, physical examination, and chest X-ray are vital for diagnosing delayed traumatic diaphragmatic hernias.
    • Prompt diagnosis and management are essential to prevent severe complications like strangulation.