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Related Experiment Videos

[Traumatic diaphragmatic hernias: retrospective analysis].

J P A Sousa1, J P Baptista, L Martins

  • 1Serviço de Medicina Intensiva, Hospitais da Universidade de Coimbra

Revista Portuguesa De Pneumologia
|September 13, 2006
PubMed
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Traumatic diaphragmatic hernias (TDH) most often affect the left side following closed thoraco-abdominal trauma, typically from road accidents. Patients, though younger, experience longer hospital stays but have lower mortality rates, highlighting the need for high clinical suspicion for diagnosis.

Area of Science:

  • Trauma Surgery
  • Thoracic Surgery
  • Emergency Medicine

Background:

  • Traumatic diaphragmatic hernias (TDH) are rare but severe injuries.
  • Diagnosis and management can be challenging, especially in critically ill patients.

Purpose of the Study:

  • To classify cases of traumatic diaphragmatic hernias (TDH) in Intensive Care Unit (ICU) patients.
  • To analyze the characteristics, diagnosis, and outcomes of TDH.

Main Methods:

  • Retrospective analysis of 34 TDH cases admitted to Coimbra University Hospitals (1990-2004).
  • Evaluation of anatomical location, diagnosis timing, herniated organs, associated injuries, morbidity, and mortality.

Main Results:

  • TDH predominantly occurred on the left side (94.1%) in male patients following closed thoraco-abdominal trauma.

Related Experiment Videos

  • The stomach was the most commonly herniated organ, with frequent associated thoracic (pulmonary contusion, haemothorax, pneumothorax) and abdominal (haemoperitoneum, splenic lesion) injuries.
  • Complication and mortality rates were 55.8% and 11.7%, respectively; diagnosis was often delayed or intra-operative.

    • Conclusions:

    • TDH typically results from closed thoraco-abdominal trauma, often road traffic accidents, affecting younger patients with lower SAPS scores but longer ICU stays.
    • Pre-operative diagnosis is difficult, necessitating a high index of clinical suspicion for diaphragmatic injuries after thoraco-abdominal trauma.