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Traumatic diaphragmatic hernia: a continuing challenge.

G L Brown, J D Richardson

    The Annals of Thoracic Surgery
    |February 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

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    Traumatic diaphragmatic hernias are often missed in trauma patients, leading to delayed diagnosis and complications. Early suspicion based on chest imaging is crucial for timely intervention and preventing long-term issues.

    Area of Science:

    • Trauma Surgery
    • Thoracic Surgery
    • Emergency Medicine

    Background:

    • Traumatic diaphragmatic hernia is a rare but significant injury in polytrauma patients.
    • Delayed diagnosis can lead to serious complications like bowel obstruction and strangulation.

    Purpose of the Study:

    • To review the diagnosis and management of traumatic diaphragmatic hernias.
    • To highlight the incidence and presentation of these injuries.

    Main Methods:

    • Retrospective review of 41 patients treated for traumatic diaphragmatic hernias between 1957 and 1982.
    • Analysis of injury mechanisms, diagnostic methods, surgical approaches, and outcomes.

    Main Results:

    • 95% of hernias resulted from blunt trauma, with left-sided injuries more common (29 vs. 14 right-sided).

    Related Experiment Videos

  • Chest radiographs were often abnormal but not always diagnostic; peritoneal lavage had limited diagnostic value.
  • Mortality was 17% due to associated injuries; one case of delayed diagnosis after 45 years was noted.

    • Conclusions:

    • Traumatic diaphragmatic hernia should be suspected in trauma patients with abnormal chest radiographs.
    • Right-sided injuries may require combined laparotomy and thoracotomy for effective treatment.
    • Organized emergency care is vital to prevent long-term sequelae from diaphragmatic injuries.