Traumatic diaphragmatic hernia-our experience.
OBJECTIVE
To review our experience in the management of traumatic diaphragmatic hernia.


METHODS
The records of all patients operated for diaphragmatic hernia between January 1998 and October 2008 at S.D.S Sanitorium and Rajiv Gandhi Institute of Chest Diseases, Bangalore, India were reviewed. Details of their clinical presentation, mode of diagnosis, operative findings and postoperative outcome were analysed.


RESULTS
Twenty nine patients underwent surgery for traumatic diaphragmatic hernia. The cause of rupture was blunt trauma in 24(83%) patients and penetrating trauma in 5(17%) patients. In 21 (72%) patients the diagnosis was made within 24 hrs and in 8(28%) patients the diagnosis was made after 24 hrs. Thoracotomy was the most common surgical approach used in 20(69%) patients. Post operative morbidity was 24% and mortality was 13.8%.


CONCLUSIONS
X-ray chest is still very useful in the diagnosis of diaphragmatic ruptures. Right sided ruptures are difficult to diagnose. Diaphragmatic hernia repair can be done through a thoracotomy with acceptable results in patients without concomitant intra abdominal injuries.
Department of Cardiothoracic Surgery, Sri Jayadeva Institute of Cardiology, Bangalore, Karnataka, India. murfad@hotmail.com
Syed Murfad
SM
Peer
Patil Mallikarjun
PM
Devaraddeppa
Shashidhar
S
Buggi
D000007:Abdominal Injuries / Q000150:complications; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D042241:Early Diagnosis; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006549:Hernia, Diaphragmatic, Traumatic / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D006801:Humans; D007194:India; D015601:Injury Severity Score; D007813:Laparotomy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D013898:Thoracic Injuries / Q000150:complications; D013908:Thoracotomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications; D014950:Wounds, Penetrating / Q000150:complications; D055815:Young Adult