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Traumatic diaphragmatic hernia.

D N Adamthwaite

    Surgery Annual
    |January 1, 1983
    PubMed
    Summary

    Traumatic diaphragmatic hernias require increased clinical awareness. Chest X-rays are the best diagnostic tool, and abdominal surgery is recommended for repair.

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    Area of Science:

    • Trauma Surgery
    • Thoracic Surgery
    • Surgical Diagnostics

    Background:

    • Traumatic diaphragmatic hernias (TDH) are uncommon but serious injuries.
    • Diagnosis and management can be challenging, necessitating improved clinical awareness.

    Purpose of the Study:

    • To review the etiology, diagnosis, and management of TDH.
    • To present a personal series of 61 TDH cases.
    • To advocate for specific diagnostic and surgical approaches.

    Main Methods:

    • Review of 61 cases of traumatic diaphragmatic hernias.
    • Analysis of diagnostic modalities including chest roentgenograms, thoracoscopy, barium contrast studies, and computerized tomographic (CT) scanning.
    • Evaluation of surgical repair approaches, emphasizing the abdominal (laparotomy) route.

    Main Results:

    • Chest roentgenograms identified as the most effective diagnostic method.
    • Thoracoscopy recommended for hernias within 24 hours of injury.
    • Barium studies cautioned in acute crisis; CT scanning shows increasing value but not routine use.
    • Abdominal approach (laparotomy) successfully repaired 58 of 61 hernias.

    Conclusions:

    • Increased clinical awareness of TDH is crucial.
    • Chest roentgenograms are the primary diagnostic tool.
    • The abdominal approach via laparotomy is a highly effective method for TDH repair.

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