Management of Traumatic Diaphragmatic Hernia: A Single Center Study
Abstract
Introduction:Traumatic diaphragmatic hernia may occur after both blunt and penetrating injuries involving thorax and abdomen. The rate of diaphragmatic rupture is 10-15% with thoracic injuries. Laparotomy is preferred particularly for left-sided injuries but thoracotomy and Video Assisted Thoracoscopic Surgery have equal favorable outcome for the treatment of traumatic diaphragmatic hernia.
Methods:This is the hospital based retrospective study, carried out over the period of 3 years from July 2017 to July 2019, in the department of Cardio Thoracic and Vascular Surgery of Bir Hospital, Nepal. Patients who underwent thoracotomy for traumatic diaphragmatic hernia repair during this period were enrolled for the study.
Results: Total of 7 cases of patients with the diagnosis of traumatic diaphragmatic hernia were treated. The age of the patient ranges from 21 to 75 years, with the mean age of 54.4. Out of total 7 patients, 5 patients underwent surgery via thoracotomy and 2 patients were treated with Video Assisted Thoracoscopic Surgery. Two cases (28.58%) were treated by simple repair with interrupted prolene No 1, while 5 (71.43%) patients were treated with mesh repair. There was one case of mortality who succumbed to trauma after surgery due to septicaemia.
Conclusions: Diaphragmatic Hernia is an infrequent complication of trauma. High morbidity and mortality make prompt surgical intervention mandatory. In stable patients, Video Assisted Thoracoscopic Surgery is safe and well tolerated with less post-operative morbidity and better cosmesis.
Keywords: Mesh Repair; Traumatic Diaphragmatic Hernia; Video Assisted Thoracoscopic Surgery
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