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Traumatic diaphragmatic hernia

J H Payne, A E Yellin

    Archives of Surgery (Chicago, Ill. : 1960)
    |January 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Traumatic diaphragmatic hernia (TDH) can be acute or chronic, often presenting with chest pain or dyspnea. Diagnosis relies on imaging, with surgery being the primary treatment for these diaphragmatic injuries.

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    Area of Science:

    • Trauma Surgery
    • Thoracic Surgery
    • Diagnostic Imaging

    Background:

    • Traumatic diaphragmatic hernia (TDH) results from blunt or penetrating injuries.
    • TDH can manifest acutely or be diagnosed years after the initial trauma.
    • Symptoms include chest pain, abdominal pain, and dyspnea.

    Purpose of the Study:

    • To review the clinical presentation, diagnosis, and management of traumatic diaphragmatic hernia.
    • To differentiate between acute and chronic TDH presentations.
    • To analyze outcomes and mortality associated with TDH.

    Main Methods:

    • Retrospective review of 36 patient records with traumatic diaphragmatic hernia.
    • Analysis of injury mechanisms (blunt vs. penetrating), clinical symptoms, and diagnostic findings.

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  • Evaluation of surgical interventions (celiotomy, thoracotomy) and patient outcomes.

    • Main Results:

    • 22 of 36 patients had chronic TDH diagnosed late after injury.
    • Blunt trauma caused 7 acute and 4 chronic TDHs; penetrating trauma caused 7 acute and 18 chronic TDHs.
    • Chest roentgenograms were abnormal in 33 patients, with pleural effusion and abnormal diaphragmatic contour being common; supradiaphragmatic bowel was pathognomonic.

    Conclusions:

    • Traumatic diaphragmatic hernia requires prompt diagnosis and surgical intervention.
    • Chronic TDH presents diagnostic challenges due to delayed presentation.
    • Mortality is associated with comorbidities like CNS injury and chronic pulmonary disease.