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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2001 February;14(1):35-8
Traumatic diaphragmatic hernia. Personal experience
Ragazzi R., Pace G., Cremona S., Vaccaro R., Di Pietro S., Buttafuoco A., Pluchino D., Ragazzi S.
The authors point out that traumatic lesions of the diaphragm are becoming increasingly frequent, especially after thoracoabdominal lesions, and mainly consist of macrolacerations with immediate diaphragmatic hernia. These lesions are more common in the left hemi-diaphragm (89%) and less frequent in the right hemi-diaphragm (11%) owing to the buffer action of the liver.
Three cases of traumatic diaphragmatic hernias observed in the past few years are reported. Two patients presented multiple injuries with extensive left diaphragmatic laceration with herniation of the stomach, spleen, left colon and epiploon into the left hemithorax; in one patient the injury was exceptionally violent, provoking right diaphragmatic laceration that was wide enough to allow the liver to be dislodged into the hemithorax causing hemothorax, shock and severe respiratory failure, which further complicated the patient's already serious condition.
In the three cases described with severe diaphragmatic lesions or exceptional injuries as in the 3rd case, the rapidity of surgery using appropriate techniques depending on the difficulty of the case, enabled each case to be resolved successfully.