[Injuries of the diaphragm]

The author presents an analysis of 27 injuries of the diaphragm treated at the surgical Clinic of the Faculty Hospital in Plzen in 1969-1992. There was a total of 22 closed injuries, all part of multiple injuries. In five instances an open injury was involved. The total mortality was 22.2%. The authors analyze the causes of injuries of the diaphragm, affections of different parts of the body in relation to multiple injuries and discuss the problem of assessment of the diagnosis. In the diagnosis in addition to common X-ray methods, sonography and CT and in exceptional cases angiography of the hepatic artery proved useful. The authors draw attention to the difference between prolapse of internal organs and post-traumatic diaphragmatic hernia and emphasize the importance of early operation after the diagnosis was established. They discuss approaches to surgical repair, treatment of injured internal organs and the diaphragm.