Publication: Delayed presentation of posttraumatic diaphragmatic hernia
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Date
2011-03-01
Authors
Authors
Okan, İSMAİL
ZİYADE, SEDAT
Bas, GÜRHAN
Alimoglu, ORHAN
Eryilmaz, RAMAZAN
Guzey, DENİZ
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Abstract
BACKGROUND
Missed diaphragmatic injuries after trauma may present
with herniation of intraabdominal organs into the thoracic
cavity. We aimed to review our patients who presented with
delayed posttraumatic diaphragmatic hernia.
METHODS
A retrospective review of the medical records of patients
with delayed diagnosis of posttraumatic diaphragmatic hernia between 2001 and 2009 was performed.
RESULTS
Ten patients with a mean age of 44.3 years were included.
Six patients were female. Blunt injuries (n: 7) were more
common. Mean duration between trauma and presentation
to the hospital was 5.9 years (4 months - 19 years). Nine
patients had left-sided diaphragmatic hernia. All patients
had chest X-ray and most were diagnostic (n: 8). Additional diagnostic imaging with computerized tomography (CT)
and magnetic resonance (MR) was used in seven patients.
For the repair, laparotomy incision was chosen for seven
patients and thoracotomy incision for two patients. One
patient underwent left thoracoabdominal approach. Mesh
repair was used in seven patients. Postoperative mean hospitalization was 10.6 days. Empyema and atelectasis were
the morbidities in one patient. No postoperative mortality
was detected.
CONCLUSION
Delayed presentation of posttraumatic diaphragmatic hernia is a serious challenge for trauma surgeons. Prompt diagnosis and treatment prevent serious morbidity and mortality associated with complications such as gangrene and/or
perforation of the herniated organ.
Key Words: Diaphragmatic hernia; delayed presentation;
posttraumatic; traumatic diaphragmatic injury.
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Citation
ZİYADE S., -Delayed presentation of posttraumatic diaphragmatic hernia-, Ulus Travma Acil Cerrahi Derg, no.3, ss.435-439, 2011