Traumatic Diaphragmatic Rupture. Experience of 40 Cases

Abstract

Objective: Experience with traumatic diaphragmatic hernias was reviewed to identify pitfalls in the diagnosis and treatment of this injury.Material and Methods: A Computerized chart review of all patients admitted to the Thoracic Unit with traumatic diaphragmatic ruptures was undertaken for the period of January 2001 to June 2010Results: We retrospectively analyzed 40 patients who presented between January 2001 and June 2010 with traumatic diaphragmatic rupture, caused by blunt injuries in 33 (82.5%) and by penetrating Injuries in7 (17.5%).there were 36(90%) cases of acute diaphragmatic rupture and 4(10%) cases of post traumatic hernia. Average age of the patients was 30 years ranging from 12-70 years. Traumatic diaphragmatic hernia was right-sided in 5 (27.8%) patients and left-sided in 13 (72.2%). The diagnosis was made by chest X-ray, thorax and upper abdominal computed tomography, and upper Gastrointestinal contrast study. The most common herniated organs were omentum (n=11), stomach (n=10), Spleen and colon (n=9), small gut (n= 8) and liver (n=2). Repair of diaphragmatic hernia was performed through a thoracotomy in 36 cases and in 4 cases through thoracolaprotomy.The mortality rate was 7.5% (n=3). Chest pain, abdominal pain, Or dyspnea were the predominant symptomsConclusions: Early diagnosis and treatment reduce intra-and post-operative morbidity and mortality