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Delayed presentation of posttraumatic diaphragmatic hernia

Ismail Okan1, Gürhan Baş, Sedat Ziyade

  • 1Department of General Surgery, Gaziosmanpaşa University, Faculty of Medicine, Tokat, Turkey. hismailok@yahoo.com

Ulusal Travma Ve Acil Cerrahi Dergisi = Turkish Journal of Trauma & Emergency Surgery : TJTES
|November 18, 2011
PubMed

Insights

Delayed diaphragmatic hernias after trauma pose a surgical challenge. Early diagnosis and repair of these posttraumatic diaphragmatic hernias are crucial to prevent severe complications and mortality.

Area of Science:

  • Trauma Surgery
  • Thoracic Surgery
  • Surgical Outcomes

Background:

  • Missed diaphragmatic injuries can lead to delayed presentation of diaphragmatic hernias.
  • Intra-abdominal organs may herniate into the thoracic cavity, complicating trauma cases.

Purpose of the Study:

  • To review patients with delayed posttraumatic diaphragmatic hernia.
  • To analyze the presentation, diagnosis, and management of these hernias.

Main Methods:

  • Retrospective review of medical records from 2001-2009.
  • Inclusion of patients with delayed diagnosis of posttraumatic diaphragmatic hernia.
  • Analysis of imaging, surgical approach, and outcomes.

Main Results:

  • Ten patients (mean age 44.3 years) were included, with blunt trauma being most common.
  • Mean delay from trauma to presentation was 5.9 years; most hernias were left-sided.
  • Chest X-ray was diagnostic in most cases; CT and MR imaging were used adjunctively. Laparotomy was the preferred surgical approach, with mesh repair in most cases. Mean hospitalization was 10.6 days with low morbidity and no mortality.

Conclusions:

  • Delayed posttraumatic diaphragmatic hernia presents a significant challenge in trauma surgery.
  • Prompt diagnosis and surgical intervention are essential to avoid life-threatening complications like organ strangulation.
Abstract

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