Surgical Management of Herniated Intrathoracic Gastric Perforation in Traumatic Diaphragmatic Rupture: An Unusual Two Rare Cases

Okyere, Isaac; Singh, Sanjeev; Okyere, Perditer; Brenu, Samuel Gyasi; Amoabeng, Samuel Kontor

doi:10.4236/ojts.2020.102006

Cited by 1 publication

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“…In Ghana, comprehensive data on diaphragmatic rupture are scanty. The only data available are two publications by Okyere et al , with one on right diaphragmatic rupture associated with hepatothorax and the other on left diaphragmatic rupture with herniated intrathoracic gastric perforation [ 13 , 14 ]. Therefore, this study was aimed at evaluating the surgical management of traumatic diaphragmatic rupture in our institution over a ten-year period looking at the surgical approach and repair technique per the specialty that managed the case and the general outcome of the patients.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of traumatic diaphragmatic rupture: ten-year experience in a Teaching Hospital in Ghana

Okyere¹,

Mensah²,

Singh³

et al. 2022

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Introduction Diaphragmatic injuries may be associated with thoracoabdominal blunt or penetrating traumas. The diagnosis is often delayed, despite the availability of several medical imaging modalities. The surgical management remains controversial, in terms of the choice of surgical approach and the surgical repair technique. Aim To evaluate the surgical management experience of traumatic diaphragmatic rupture in our institution over a ten-year period in the local setting of a tertiary hospital in Ghana. Material and methods A retrospective review of the medical records of patients who had undergone surgery for traumatic diaphragmatic rupture. Results A total of 35 cases of diaphragmatic rupture were seen from thoracoabdominal injuries. There were 29 (82.86%) males. The mean age was 36.25 ±12.98 years with a range of 16–65 years. There were 3 cases of right diaphragmatic rupture and 32 cases of left diaphragmatic rupture. Penetrating chest injury caused 18 (51%) of the ruptures. The leading cause of injury was road traffic accident, which constituted 48.57%, closely followed by stab (25.71%), gunshot injuries (14.29%) and impalement injury (11.48%). Seventeen (49%) patients had their diaphragmatic ruptures repaired via laparotomy and the remaining 18 (51%) via thoracotomy. The commonest herniated organ was the stomach. One patient died in theatre from cardiac arrest after failed intubation. Conclusions Surgery is the treatment of choice in traumatic diaphragmatic rupture and it is repaired via laparotomy or thoracotomy based on the presence or absence of concomitant abdominal injury and the presence or absence of a cardiothoracic surgeon.

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Section: Introductionmentioning

confidence: 99%