Delayed diaphragmatic hernia after open trauma with unusual content: Case report

Costa, Ketlen Gomes da; Silva, Rafaelle Taynah Soares da; Melo, Marineide Santos de; Pereira, Jade Thays Saldanha; Rodriguez, Juan Eduardo Rios; Souza, Renato Carvalho Amaral de; Medeiros, Izabela Augusta de Oliveira

doi:10.1016/j.ijscr.2019.08.030

Cited by 11 publications

(10 citation statements)

References 14 publications

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“…Thoracic and abdominal access is commonly discussed in the current literature without a consensus about which technique is best. The actual agreement is that thoracotomy is indicated when the hernia presents late, meanwhile laparotomy is most appropriate immediately after trauma [11] . The main principles of hepatothorax repair due to traumatic diaphragmatic hernia include decompression, reducing the hernia back into the abdominal cavity, and ensuring secure closure of the diaphragmatic defect [3] .…”

Section: Discussionmentioning

confidence: 99%

Delayed hepatothorax: An unusual presentation case report

Maldonado-Chaar

Miró-González

Ramírez

et al. 2022

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Delayed hepatothorax: An unusual presentation case report

Maldonado-Chaar

Miró-González

Ramírez

et al. 2022

International Journal of Surgery Case Reports

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“…As mentioned above, there were 4 delayed diagnoses which were confirmed 4 months to 12 years later after discharge from hospital. Delayed or missed diagnoses may place patients at risk for morbidity and mortality [ 27 – 29 ]. In some cases, it could be insidious for delayed hernia formation or small openings [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of traumatic diaphragmatic hernia: a single institutional experience of more than two decades

Deng

Huang

2021

BMC Surg

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Background We present here our experience with surgical management of traumatic diaphragmatic hernia, trying to find out the era impact of different periods on the outcome and risk factors of mortality. Methods A series of 63 patients with traumatic diaphragmatic hernia were referred to us and operated on during March, 1990-August, 2017. The patient records were reviewed and statistically analyzed to demonstrate injury characteristics and to find out optimal treatment strategy, risk factors of death as well as the difference between two periods (1990–2005, 2005–2017) divided by introduction of computed tomography at our institution. Results The overall mean age was 31.2 ± 16.3 years old with a female to male ratio of 11/52. The mechanism was penetrating trauma in 19 cases (30.2%), and blunt trauma in 44 cases (69.9%). Two thirds of the patients in the second group (2005–2017) yet none in the first group (1990–2005) underwent computed tomography. Ten patients (15.9%), of which 8 in the first and the other 2 in the second group (p = .042), had late diagnoses. The most commonly used incision was a thoracotomy (n = 43, 89.6%). There was no statistical difference in etiology or mortality between the two periods. Univariate analysis showed survivors were younger, and had lesser injury severity scores (ISS) and lower American Association for the Surgery of Trauma (AAST) grade than non-survivors. By multivariate logistic regression analysis, increased age (odds ratio, 1.275; p = .013) and greater ISS (OR, 1.174; p = .028) were risk factors of death in all patients. Conclusions High-definition computed tomography has significantly improved the preoperative diagnosis rate. The transthoracic approach could be used in selected cases with traumatic diaphragmatic hernia with good outcomes. Patients with greater ISS and advanced ages are at a higher risk of death.

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“…The overall mortality was 27%. A recent case report by da Costa, et al 12 reported diagrammatic hernia with the displacement of abdominal viscera and two accessory spleens in a patient who had a history of stab trauma 9 years back. At the time of the injury, the trauma was managed with chest drainage without any evidence of abdominal injury.…”

Section: Discussionmentioning

confidence: 99%

Delayed presentation of left traumatic diaphragmatic hernia with displacement of spleen and stomach to left hemi thorax

Marzban-Rad

Sattari²,

Taheri

2020

Clinical Case Reports

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Delayed diaphragmatic hernia after open trauma with unusual content: Case report

Abstract: HighlightsThey are classic signs of progression in the presence of a hidden lesion in the diaphragm.The presence of the reported accessory spleen is only a possible variation.The use of thoracotomy is more indicated in cases with a later diagnosis.

Cited by 11 publications

References 14 publications

Delayed hepatothorax: An unusual presentation case report

Delayed hepatothorax: An unusual presentation case report

Surgical management of traumatic diaphragmatic hernia: a single institutional experience of more than two decades

Delayed presentation of left traumatic diaphragmatic hernia with displacement of spleen and stomach to left hemi thorax

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