Traumatic diaphragmatic hernias: a report of 26 cases

Abstract

Traumatic diaphragmatic hernias, when diagnosed many years after the traumatic event, are observed in about 10% of diaphragmatic injuries. Due to coexisting injuries and the silent nature of diaphragmatic injuries, the diagnosis is easily missed or difficult. The medical records of 26 patients, who were treated for diaphragmatic hernias during the last 20 years, were analysed retrospectively. The patients were divided into acute phase and late-presenting groups, in whom emergency surgery and elective intervention were performed respectively. Chest radiography was diagnostic in 34.6% (n = 9) of patients. 92.3% of the hernias were on the left side, while the most common herniated organs were the stomach (31.8%) and the colon (27.2%). Coexisting injuries were recorded in 38.4% (n = 10) of the patients. Primary repair was predominantly used (92.3%). The hospitalisation period was longer in the late-presenting group (24.1 +/- 18.8 vs. 14.3 +/- 7.7 days). Two deaths occurred in the late-presenting group. Diaphragmatic hernia should be suspected in all blunt abdominal trauma patients. Prompt surgical repair is the treatment of choice in all traumatic diaphragmatic hernias.

Colobronchial Fistula Complicating a Traumatic Right Diaphragmatic Hernia: A Case Report

“…It has been suggested that right-sided diaphragmatic injury is more common in right-hand drive cars [4]. Two to six percent of major trauma patients sustains diaphragmatic injury [5], usually in association with other organ injury. It is more common when rib fractures are seen in association with pelvic fracture [6].…”

Original article An extremely rare clinical condition: isolated post-traumatic diaphragmatic injuries

“…Moreover, rates of 1-7% and 10-15% have been reported after blunt and penetrating traumas, respectively [2]. The TDRs, which are rare clinical entities, are not detected in 90% of cases admitted to emergency departments after trauma [3]. A definitive diagnosis cannot be made after the first evaluation in more than half of cases and may be easily missed due to other more prominent symptoms related to other organ systems [4,5].…”

“…An asymptomatic clinical course can occur after isolated post-traumatic diaphragmatic ruptures, and the diagnosis is often established in a delayed manner after development of a herniation that leads to progressive symptoms. Post-traumatic isolated diaphragmatic ruptures have no specific clinical symptoms and signs; therefore, cases have been reported in which the diagnosis was made years later [3].…”

Hérnia diafragmática direita tardia associada a hepatotórax - relato de caso com revisão da literatura

“…Os defeitos tendem a ser largos, usualmente entre 10 a 15 cm 17 . Os órgãos que podem herniar através do defeito incluem o estômago, cólon, omento, alças de delgado e fígado, nesta ordem de frequência 14 . A hemicúpula diafragmática direita geralmente é envolvida em 15% a 24% dos casos, a esquerda em 70% a 80%, sendo que em 5% a 8% o comprometimento é bilateral.…”