[Surgical policy in complicated traumatic diaphragmatic hernias]

Rare variants of surgical policy in different terms after traumatic diaphragmatic hernias complicated with necrosis and perforation of gastric walls and abdominal part of esophagus, ulcerous gastric bleedings, empyema of pleura, enzymatic-gangrenous destruction of lung, cachexia are analyzed. Necessity of revision of diaphragm during surgery for diagnosis of it injuries is noted. In old diaphragmatic hernias and significant disposition of intraabdominal organs into pleural cavity thoracotomy or thoracophrenolaparotomy are recommended, in acute trauma when symptoms of abdominal injuries dominate laparotomy is expedient. In severe conditions minimal and organ-saving surgeries are recommended. Creation of "small stomach" from remains of its wall may be considered as alternative to traumatic gastrectomy.