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[Traumatic diaphragmatic hernia in children]
J M Mariño1, M J Martínez-Urrutia, M López-Santamaria
1Departamento de Cirugía Pediátrica, Hospital Infantil La Paz, Universidad Autónoma de Madrid.
Insights
This study details the successful surgical repair of traumatic diaphragmatic hernias in three children following blunt abdominal trauma. The transabdominal approach using non-absorbable sutures proved effective for these emergency cases.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Thoracic Surgery
Background:
- Traumatic diaphragmatic hernia (TDH) is a rare but serious consequence of blunt abdominal trauma.
- Prompt diagnosis and surgical intervention are critical for patient outcomes.
Observation:
- Three pediatric cases of TDH following blunt abdominal trauma were analyzed.
- Hernias were predominantly right-sided, with associated liver and lung injuries in two patients.
- Posterolateral diaphragm rupture was the most common site.
Findings:
- Chest radiography effectively suspected TDH pre-operatively.
- The transabdominal surgical approach was efficacious for repairing diaphragmatic defects.
- Non-absorbable interrupted mattress sutures were utilized for repair, avoiding prosthetic materials.
Implications:
- The transabdominal approach is a viable emergency treatment for pediatric traumatic diaphragmatic hernias.
- Non-absorbable sutures offer a reliable method for diaphragmatic repair without mesh.
- Early diagnosis via chest radiography is crucial for timely surgical management.
Abstract:
We have treated three children with traumatic diaphragmatic hernia appearing after blunt abdominal trauma. The hernia was on the right side in two patients and was accompanied by liver and lung injuries. The most common site of diaphragmatic rupture was the postero-lateral area in both sides. Diagnosis was suspected in all of them with chest radiograph before operative management. The transabdominal approach has proven to be efficacious in repairing the defects and often require emergency care. The diaphragmatic repair was performed using non absorbable interrupted mattress sutures. No prosthetic materials were required.