Skip to main content

Traumatic diaphragmatic hernias: a report of 26 cases

Hernia volume 5, pages 25–29 (2001)Cite this article

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  • Arendrup HC, Arendrup KD (1989) Traumatic diaphragmatic hernia. In: Nyhus LM, Condon RE (eds) Hernia 3rd ed. JB Lippincott Company, Philadelphia, pp 708–716

    Google Scholar 

  • Athanassiadi K, Kalavrouziotis G, Athanassiou M, Vernikos P, Skrekas G, Poultsidi A, Bellenis (1999) Blunt diaphragmatic rupture. Eur J Cardiothorac Surg 15:469–74

    Google Scholar 

  • Ball T, McCrory R, Smith JO, Clements JL (1982) Traumatic diaphragmatic hernia: Errors in diagnosis. AJR 138:633–637

    Google Scholar 

  • Brown GL, Richardson JD (1985) Traumatic diaphragmatic hernia: a continuing challenge. Ann Thorac Surg 39:170–173

    Google Scholar 

  • Cruz CJ, Minagi H (1994) Large-bowel obstruction resulting from traumatic diaphragmatic hernia:imaging findings in four cases. AJR 162:843–845

    Google Scholar 

  • Freixinet JL, Segur JM, Mestres CA, Mateu M, Gimferrer JM, Catalan M, Callejas MA, Letang E, Sanchez-Lloret J (1987) Traumatic injuries of the diaphragm. Experience in 33 cases. Thorac Cardiovasc Surg 35:215–218

    Google Scholar 

  • Kurata K, Kubota K, Oosawa H, Eda N, Ishihara T (1996) Thoracoscopic repair of traumatic diaphragmatic rupture. A case report. Surg Endosc 10:850–1

    Google Scholar 

  • Lee WC, Chen RJ, Fang JF, Wang CC et al (1994) Rupture of the diaphragm after blunt trauma. Eur J Surg 160:479–483

    Google Scholar 

  • Lorimer JW, Reid KR, Raymond F (1994) Blunt extraperitoneal rupture of the right hemidiaphragm: case report. J Trauma 36:414–416

    Google Scholar 

  • Meyers BF, McCabe CJ (1993) Traumatic diaphragmatic hernia: Occult marker of serious injury. Ann Surg 218 (6):783–790

    Google Scholar 

  • Moore EE, Cogbill TH, Malangoni MA, Jurkovich GJ, Shackford SR, Champion HR, McAninch JW (1995) Organ injury scaling. Surg Clin N Amer 75:293–303

    Google Scholar 

  • Nano M, Dei Poli M, Mossetti C, Maggi G (1980) Traumatic diaphragmatic hernias. Surg Gynecol Obstet 151:191–192

    Google Scholar 

  • Payne JH, Yellin AE (1982) Traumatic diaphragmatic hernia. Arch Surg 117:18–24

    Google Scholar 

  • Rasiah KK, Crowe PJ (1995) Laparoscopic repair of a traumatic diaphragmatic hernia. J Laparoendosc Surg 5:405–7

    Google Scholar 

  • Shah R, Sabanathan S, Mearns AJ, Choudhury AK (1995) Traumatic rupture of diaphragm. Ann Thorac Surg 60:1444–1449

    Google Scholar 

  • Shackleton KL, Stewart ET, Taylor AJ (1998) Traumatic diaphragmatic injuries: spectrum of radiographic findings. Radiographics 18:49–59

    Google Scholar 

  • Shires GT, Thal ER, Jones RJ, Shires GT, Perry MO (1994) Trauma. In: Schwartz SI, Shires GT, Spencer FC, Husser WC (eds) Principles of Surgery 6th ed. McGraw-Hill Inc, New York, pp 175–225

    Google Scholar 

  • Simon RJ, Ivatury RR (1985) Current concepts in the use of cavitary endoscopy in the evaluation and treatment of blunt and penetrating truncal injuries Surg Clin N Amer 75:157–174

    Google Scholar 

  • Symbas PN, Vlasis SE, Hatcher C (1986) Blunt and penetrating diaphragmatic injuries with or without herniation of organs into the chest. Ann Thorac Surg 42:158–162

    Google Scholar 

  • Troop B, Myers RM, Agarwal NN (1985) Early recognition of diaphragmatic injuries from blunt trauma. Ann Emerg Med 14:97–101

    Google Scholar 

Download references

Author information

Affiliations

  1. General Surgery Department Dr. Turgut Noyan Research Hospital, Baskent University, Adana, Turkey

    T. Z. Nursal

  2. General Surgery Department, Hacettepe University Hospital, Ankara, Turkey

    M. Ugurlu, M. Kologlu & E. Hamaloglu

Authors
  1. T. Z. Nursal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Ugurlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Kologlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Hamaloglu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to T. Z. Nursal.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Nursal, T.Z., Ugurlu, M., Kologlu, M. et al. Traumatic diaphragmatic hernias: a report of 26 cases. Hernia 5, 25–29 (2001). https://doi.org/10.1007/BF01576161

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01576161

Key words

  • Diaphragmatic hernia
  • Trauma
  • Blunt abdominal trauma