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Delayed presentation of blunt traumatic diaphragmatic hernia: A case report
AT Kidmas, D Iya, ES Isamade, E Ekedigwe
Nigerian Journal of Surgical Research , 2005,
Abstract: Blunt traumatic diaphragmatic rupture is an uncommon but severe problem that is usually seen in poly-traumatized patients. Diagnosis is often difficult resulting in delayed presentation and increased morbidity. We report a case of blunt traumatic diaphragmatic hernia in a 39-year-old man presenting 10 years after the initial abdomino-thoracic injury sustained in a road traffic accident. He had herniation of the spleen and stomach. Through a left thoracotomy, the herniated organs were reduced and diaphragmatic defect closed with interrupted nylon sutures. A high index of suspicion would minimize the morbidity and mortality associated with delayed diagnosis.
Traumatic diaphragmatic hernia: case report  [cached]
Miguel Angel Serra Valdés,Mario Achon Polhamus,Maria de Lourdes Menéndez Villa,Liudmila Carnesoltas Suarez
Medwave , 2013,
Abstract: Introduction. Traumatic diaphragmatic hernias occur after blunt or penetrating trauma. The case reported in this article is an incidental and unusual diagnosis in clinical practice. Case. We report a woman with a history of thoraco-abdominal trauma from a road accident that occurred 30 years ago. In the chest X-ray we found a radioopacity in the right lung base resulting from a respiratory infection. The image persisted in spite of effective treatment for the underlying respiratory condition, which made us suspect a diaphragmatic hernia corroborated by computed tomography. Discussion. A high level of suspicion is essential for the initial evaluation of patients with blunt or penetrating thoraco-abdominal trauma. Conclusions. Traumatic diaphragmatic hernias constitute a clinical challenge both for diagnosis and surgical treatment.
Delayed presentation of a traumatic diaphragmatic hernia  [cached]
Chi-Tun Tang,Ming-Ying Liu,Chi-Tun Tang
Signa Vitae , 2011,
Abstract: Delayed presentation of a traumatic diaphragmatic hernia is an infrequent condition with a high mortality and morbidity rate. This case describes a 26-year-old man presenting with a 2-day history of cramping abdominal pain, dyspnea, nausea, and vomiting. The patient reported a penetrating thoracic injury one year prior to the development of clinical signs. Computed tomography revealed the presence of empyema or parapneumonic effusion of the left hemithorax. Based on the clinical history and physical findings, a diaphragmatic hernia was considered and an emergency laparotomy with segmental resection of strangulated jejunum and reduction of remaining bowel was performed. A 1.5 cm tendinous defect was identified and repaired. The patient recovered and was discharged uneventfully.Conclusion: the early recognition of a delayed diaphragmatic hernia contributed to the uneventful recovery of this critically ill patient.
Post Traumatic Diaphragmatic Hernia Revealing a Colonic Tumor  [PDF]
Mohammed Elkehal, Sani Rabiou, Boubacar Efared, Saad Slaiki, Hicham Elbouhadouti, Yassine Ouadnouni, Nawal Hammas, Taoufiq Harmouch, Mohamed Smahi
Open Journal of Thoracic Surgery (OJTS) , 2016, DOI: 10.4236/ojts.2016.63003
Abstract: Post traumatic diaphragmatic injuries have long been known. However their varied clinical, expressions lead to difficulties which cause its delay. The occurrence of herniation of hollow viscera in the thoracic cavity followed by its necrosis or perforation, is a delayed complication, a rare entity with a poor prognosis. The discovery of a colonic tumor in a diaphragmatic hernia is an exceptional clinical circumstance. Here we report the case of a patient with a complicated diaphragmatic hernia, whose symptoms are precipitated by the presence of a colon stenosing tumor. The management consisted of an exclusive laparotomy had allowed dealing in one surgical intervention with both the abdominal and thoracic injuries.
Traumatic diaphragmatic hernia-late presentation  [cached]
Rao PLNG,Katariya R
Journal of Postgraduate Medicine , 1979,
Abstract: The traumatic diaphragmatic hernia is an established con-sequence of modern high speed transportation. Late presentation of traumatic diaphragmatic hernia is an uncommon surgical problem. Two cases of latent and obstructive traumatic diaphragmatic hernia have been presented. The clinical presentation, the diagnostic problems and the management of such cases are discussed.
Hernia diafragmática traumática. Presentación de un caso Traumatic diaphragmatic hernia. Presentation of a case
Gilberto L Galloso Cueto,Raúl Bello Delgado,Norkis Alonso Domínguez,Ariel Jordán Alonso
Revista M??dica Electr?3nica , 2010,
Abstract: La hernia diafragmática traumática constituye un problema poco frecuente para el cirujano general, necesitándose un elevado índice de sospecha para su diagnóstico, especialmente en los pacientes portadores de un trauma cerrado. Se presenta un paciente masculino de 40 a os de edad, portador de una hernia diafragmática traumática formada por estómago y epiplón mayor, secundaria a un trauma toroco-abdominal en accidente automovilístico, en el que se práctica video toracoscopía izquierda, que permite realizar el diagnóstico correcto. Se exponen los datos clínicos del paciente, su manejo, tratamiento quirúrgico efectuado y su posterior evolución. Traumatic diaphragmatic hernia is a little frequent problem for the general surgeon, needing a high level of suspicion for the diagnosis, especially in patients carrying a closed trauma. We present the case of a male, 40-years-old patient, with a traumatic diaphragmatic hernia formed by stomach and greater omentum, secondary to a thoraco-abdominal trauma in automobile accident. A left video thoracoscopy allows arriving to the correct diagnosis. We expose the clinical data of the patient, his management, the surgical treatment applied and his subsequent evolution.
Difficult weaning in delayed onset diaphragmatic hernia  [cached]
Ahmed Syed,Nadeem Abu,Pal Jyotishka,Gupta Rahul
Journal of Emergencies, Trauma and Shock , 2009,
Abstract: Diaphragmatic injuries are relatively rare and result from either blunt or penetrating trauma. Regardless of the mechanism, diagnosis is often missed and high index of suspicion is vital. The clinical signs associated with a diaphragmatic hernia can range from no outward signs to immediately life-threatening respiratory compromise. Establishing the clinical diagnosis of diaphragmatic injuries (DI) can be challenging as it is often clinically occult. Accurate diagnosis is critical since missed DI may result in grave sequelae due to herniation and strangulation of displaced intra-abdominal organs. We present a case of polytrauma with rib fracture and delayed appearance of diaphragmatic hernia manifesting as difficult weaning from ventilatory support.
Post-Traumatic Right Diaphragmatic Hernia with Hepatothorax  [PDF]
Elias Amorim, Frederico Berniz Arag?o, Armando Veiga, Alexandre Porto Galdez
Open Journal of Thoracic Surgery (OJTS) , 2018, DOI: 10.4236/ojts.2018.81001
Abstract: Introduction: Traumatic right diaphragmatic hernia is an extremely rare entity, given the protection afforded by the liver. Clinical Case: A 51-year-old women who suffered a road-traffic accident presented with a heavy sensation and several episodes of moderate pain in the left hemithorax. Physical and radiological exams revealed a traumatic right hernia. Discussion: The diagnosis of hernia should be established as quickly as possible to reduce morbidity and mortality. Treatment of the injury is always surgical and outcome is invariably positive. Conclusion: The diagnosis of diaphragmatic hernia should
Hernia diafragmática traumática crónica: a propósito de un caso Chronic traumatic diaphragmatic hernia: a case report  [cached]
Joselín Valdés Ferro,José Daniel Díaz Díaz
Revista de Ciencias M??dicas de Pinar del R?-o , 2010,
Abstract: La hernia diafragmática traumática se presenta con relativa frecuencia en cualquier medio y se necesita de un alto índice de sospecha para su diagnóstico, especialmente en los casos de trauma cerrado. Se presenta una paciente operada por esta afección luego de sufrir un trauma cerrado abdominal 16 a os atrás, a la que se le encontró una hernia diafragmática izquierda, formada por todo el estómago, colon transverso, bazo y epiplón mayor. Se hace referencia a algunos aspectos de interés sobre esta enfermedad los síntomas que presentó la paciente, los complementarios empleados para llegar al diagnóstico, así como a los principios fundamentales para la reparación de estas lesiones. En dependencia del diámetro del anillo herniario el orificio se puede cerrar con puntos de sutura no absorbible o colocar un material protésico para cubrir el defecto, el abordaje puede ser por vía torácica, abdominal o combinada en dependencia del tiempo de evolución de la misma. Traumatic diaphragmatic hernia is relatively frequent in any conditions and needs a high rate of suspicion to be diagnosed, particularly in the cases of closed trauma. A patient who underwent an operation, due to this affection, after suffering an abdominal closed trauma, 16 years before, presented a left diaphragmatic hernia; it covered the stomach, transverse colon, spleen and the gastrocolic omentum. Some other aspects of interest about the disease and the symptoms were observed. Laboratory findings and the main principles to repair these lesions were taken into consideration to establish the diagnosis. Considering that; the diameter of the hernial ring as well as the orifice can be closed with non-absorbable suture or placing prosthetic material to cover the defect, the approach can be thoracic, abdominal or combined depending on the time of its evolution.
Hernia diafragmática traumática Traumatic diaphragmatic hernia in an adult  [cached]
Ileana Guerra Macías,José Fong Sinobas,Geovanis Castilla Castellanos
MEDISAN , 2012,
Abstract: Se describe el caso clínico de una paciente de 48 a os de edad, quien había sufrido traumatismo toracoabdominal izquierdo cerrado desde hacía 8 meses, la cual fue ingresada en el Hospital "Dr. Ambrosio Grillo Portuondo" de Santiago de Cuba por presentar dolor abdominal en hipocondrio izquierdo, de un mes de evolución. Los exámenes imagenológicos realizados confirmaron que se trataba de una hernia diafragmática izquierda, con presencia del ángulo esplénico del colon en el hemitórax izquierdo. La fémina fue intervenida quirúrgicamente y egresó sin complicaciones. The case report of a 48-year-old woman is described, who had left blunt thoracoabdominal injury for 8 months and was admitted to "Dr. Ambrosio Grillo Portuondo" Hospital of Santiago de Cuba to present with abdominal pain in left hypochondrium a month earlier. Imaging tests confirmed a left diaphragmatic hernia with presence of splenic flexure in the left hemithorax. She underwent surgery and was discharged without complications.
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