title: The Etiology, Associated Injuries and Clinical Presentation of Post Traumatic Diaphragmatic Hernia.
abstract: OBJECTIVE
  The aim of this study was to evaluate the etiology, associated injurers and clinical presentation of post traumatic diaphragmatic hernia.
  
  
  METHODS
  This study was a cross-sectional study being conducted in the department of Cardiovascular, thoracic surgery (CVTS) and Pediatric Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India. All patients of post traumatic diaphragmatic hernia who were admitted in the department of CVTS and Pediatric Surgery, SKIMS, during the course of study (May 2009 to Nov. 2011) were included.
  
  
  RESULTS
  From the commencement of the study 21 patients had traumatic diaphragmatic hernia. Most common presenting symptoms in traumatic diaphragmatic hernia were, chest discomfort and pain abdomen presented in 81% of patients, followed by breathlessness in 61.9% and vomiting in 47.6%. Common associated injuries in traumatic diaphragmatic hernia in our study group were, rib fracture in 47.6%, splenic injury in 28.6%, head injury in 23.8%, soft tissue injury in 23.8%, gut perforation in 19%, limb fracture in 14.3%, liver injury in 9.5%, pancreatic injury in 4.8% and renal injury in 4.8%.
  
  
  CONCLUSIONS
  Usually the patients of Post traumatic diaphragmatic hernia presents as emergency, early recognition and prompt surgical treatment is needed for better outcome. The Incidence of post traumatic diaphragmatic hernia when associated with blunt trauma abdomen and chest is very high (81%). A high level of suspicion is needed in these injuries. The 9.5% of traumatic diaphragmatic hernia may have delayed presentation. Early diagnosis of traumatic diaphragmatic hernia is most difficult when herniation is delayed.
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
authors.forename: Farooq Ahmad
authors.initials: FA
authors.lastname: Gaine
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
authors.forename: Ghulam Nabi
authors.initials: GN
authors.lastname: Lone
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
authors.forename: Mushtaq Ahmad
authors.initials: MA
authors.lastname: Chowdhary
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
authors.forename: Hafeezula
authors.initials: H
authors.lastname: Lone
keywords: Associated injuries; Blunt trauma; Post traumatic diaphragmatic hernia