scholarly journals Delayed Traumatic Diaphragmatic Hernia With Bacterial Pleuritis

2016 ◽  
Vol 101 (5-6) ◽  
pp. 270-274
Author(s):  
Yu Ohkura ◽  
Shusuke Haruta ◽  
Yusuke Maeda ◽  
Hisashi Shinohara ◽  
Masaki Ueno ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diaphragmatic Hernia ◽  
Diaphragmatic Rupture ◽  
Traumatic Diaphragmatic Hernia ◽  
Hernia Mesh ◽  
Reactive Protein ◽  
Traumatic Diaphragmatic Rupture ◽  
Absorbable Sutures ◽  
Abdominal Blunt Trauma ◽  
Traumatic Pneumothorax

Thoraco-abdominal blunt trauma may cause traumatic diaphragmatic hernia. Here, we report a case of delayed traumatic diaphragmatic rupture with herniation of multiple viscera along with bacterial pleuritis without perforation or necrosis. A 72-year-old man presented with severe left-sided chest pain and dyspnea following a fall in the bathroom on the previous day; he had hit the left side and back of the chest against a faucet. Computed tomography (CT) revealed pneumoderma, mediastinal emphysema, pneumothorax, and fractures of the 8th–11th left ribs. We diagnosed traumatic pneumothorax, which was treated by a thoracostomy tube inserted into the pleural space. Approximately 6 months later, he presented again with fever (39.2°C), dyspnea, and coughing. The white blood cell count and C-reactive protein were elevated at 20.3 × 103/μL and 28.7 mg/dL, respectively. A CT scan revealed left-sided pleural effusion and diaphragmatic hernia. Thoracocentesis was performed for the pleural effusion, and bacterial cultivation tests revealed Bacteroides fragilis; therefore, antibiotics were administered for 3 weeks. Subsequently, diaphragmatic hernia repair was performed. Laparotomy via a left subcostal incision revealed a defect measuring 60 × 60 mm; this was repaired with uninterrupted absorbable sutures without using a hernia mesh to avoid infection. The postoperative course was uneventful, and no recurrence was noted at the 1-year follow-up. We repaired delayed traumatic diaphragmatic rupture with herniation of multiple viscera by simple suturing without using a hernia mesh following the treatment of associated bacterial pleuritis.

scholarly journals Delayed Presentation of Traumatic Diaphragmatic Rupture with Herniation of the Left Kidney and Bowel Loops

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Amiya Kumar Dwari ◽  
Abhijit Mandal ◽  
Sibes Kumar Das ◽  
Sudhansu Sarkar
Keyword(s):  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Major Trauma ◽  
Left Kidney ◽  
Diaphragmatic Rupture ◽  
Delayed Presentation ◽  
Traumatic Diaphragmatic Hernia ◽  
Traumatic Diaphragmatic Rupture ◽  
A Minor

Rupture of the diaphragm mostly occurs following major trauma. We report a case of delayed presentation of traumatic diaphragmatic hernia on the left side in a 44-year-old male who presented two weeks after a minor blunt trauma. Left kidney and intestinals coils were found to herniate through the diaphragmatic tear. This case demonstrates the importance of considering the diagnosis in all cases of blunt trauma of the trunk. It also illustrates the rare possibility of herniation of kidney through the diaphragmatic tear.

Chronic traumatic diaphragmatic hernia: the significance of pleural effusion.

Radiology ◽  
1988 ◽  
Vol 168 (3) ◽  
pp. 675-678 ◽  
Author(s):  
J M Aronchick ◽  
D M Epstein ◽  
W B Gefter ◽  
W T Miller
Keyword(s):  
Pleural Effusion ◽  
Diaphragmatic Hernia ◽  
Traumatic Diaphragmatic Hernia

Traumatic Diaphragmatic Hernia: Late Presentation as Bloody Pleural Effusion

CHEST Journal ◽  
1974 ◽  
Vol 66 (6) ◽  
pp. 734-736
Author(s):  
William G. Murchison ◽  
William K. Harper ◽  
Jerome S. Putnam
Keyword(s):  
Pleural Effusion ◽  
Diaphragmatic Hernia ◽  
Late Presentation ◽  
Traumatic Diaphragmatic Hernia

scholarly journals Traumatic Diaphragmatic Rupture, Incidence, Presentation, and Outcome: تمزق الحجاب الحاجز الرضحي؛ مدى شيوع الإصابة والعرض والنتيجة

2021 ◽  
Vol 5 (3) ◽  
pp. 98-84
Author(s):  
Waleed Mohammed Gialan, Yasser Abdurabu Obadiel, Abdulrazzak Waleed Mohammed Gialan, Yasser Abdurabu Obadiel, Abdulrazzak
Keyword(s):  
Prospective Study ◽  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Penetrating Trauma ◽  
Length Of Hospital Stay ◽  
Diaphragmatic Rupture ◽  
Associated Injuries ◽  
Traumatic Diaphragmatic Rupture ◽  
The Right ◽  
Time Of Presentation

Objective: The aim of this prospective study is to highlight the incidence of a traumatic diaphragmatic rupture occurring in thoraco-abdominal penetrating or blunt trauma, and discuss their presentation and outcome Methods: We performed a prospective study, between 1st January 2017 to 30th June 2020 at the Department of General Surgery of the Al-Thawra Modern General Hospital, and 48-Modrn hospital -Sana'a city -Yemen. We included all the patients who were diagnosed and admitted with traumatic diaphragmatic rupture during the study period. Data included demographics, mechanism of injury, associated injuries, time of presentation post- trauma, length of hospital stay and ICU, ventilator days, management, postoperative complication, and outcomes. The variables were analyzed and compared for patients. Result: A total of 38 patients had traumatic diaphragmatic injury of (1843) thoracoabdominal trauma (2.1%)(855 blunt trauma & 988 penetrating trauma), 31 patients (81.6%) have sustained penetrating trauma, while only 7 patients (18.4%) have blunt trauma. There were 33 male patients (86.8%) and 5 female patients (13.2%) with a mean age of 25 years (range 3–52 years), the location of rupture was 30 patients (78.9%) on the left-sided, and 8 patients (21.1%) on right-sided, 4 patients presented early with a diaphragmatic hernia, and 5 patient presented late with diaphragmatic hernia. Associated injuries were presented in 36 patients (94.7%). The diagnosis was preoperatively established in (36.8%), and intraoperative (63.2%). The diaphragmatic rupture was repaired with interrupted nonabsorbable sutures. Postoperative complications were observed in 23 patients (60.5%). Mortality was observed in 4 patients (10.5%). The outcome affected by associated injuries hemo/pneumothorax, rib fractures/lung contusion, hollow viscous injury, post-operative complication, time of presentation post- trauma, and hemodynamically state before admission. Conclusion: Traumatic diaphragmatic rupture, usually masked by multiple associated injuries which aggravate the condition of patients and are responsible for morbidity and mortality. The left-sided is involved more than the right-sided.

scholarly journals Intrathoracic Acute Cholecystitis

2020 ◽  
Author(s):  
Giovana Ennis ◽  
Gabriela Venade ◽  
Joana Silva Marques ◽  
Paulo Batista ◽  
Ana Abreu Nunes ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Diaphragmatic Hernia ◽  
Traumatic Injury ◽  
Traumatic Diaphragmatic Hernia ◽  
Reactive Protein ◽  
Dark Urine ◽  
History Of ◽  
Slight Elevation ◽  
Loss Of Appetite ◽  
Work Up

The authors present the case of a 51-year-old woman with no history of surgical or traumatic injury or accident, who presented with right hypochondrium and epigastric discomfort, malaise, nausea, loss of appetite and episodes of dark urine and greenish stools. Initial laboratory work-up revealed elevated inflammatory markers including leucocytosis with left shift and C-reactive protein, and a slight elevation of gamma-glutamyltransferase and alkaline phosphatase, with no other significant alterations. Computed tomography (CT) showed intrathoracic acute cholecystitis with a large diaphragmatic hernia. A literature search revealed only one other case of acute cholecystitis complicated by intrathoracic gallbladder due to a non-traumatic diaphragmatic hernia. Symptoms are uncharacteristic and the absence of pain or fever, explained by the altered location of the gallbladder, makes the diagnosis a challenge.

scholarly journals Strangulated Tension Viscerothorax with Gangrene of the Stomach in Missed Traumatic Diaphragmatic Rupture

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Uvie Onakpoya ◽  
Akinwumi Ogunrombi ◽  
Anthony Adenekan ◽  
William Akerele
Keyword(s):  
Treatment Outcomes ◽  
Blunt Trauma ◽  
Diaphragmatic Hernia ◽  
Anterior Wall ◽  
Diaphragmatic Rupture ◽  
The Body ◽  
Rare Occurrence ◽  
Traumatic Diaphragmatic Rupture ◽  
Poor Treatment ◽  
Diaphragmatic Hernias

Acquired diaphragmatic hernias are usually posttraumatic in occurrence. In patients who have blunt trauma and associated diaphragmatic hernia, the diagnosis may be missed or delayed, often leading to poor treatment outcomes. We present a rare occurrence of tension viscerothorax due to missed traumatic diaphragmatic rupture in a 25-year-old woman whose condition was complicated by gangrene and perforation of the fundus as well as questionable viability of the anterior wall of the body of the stomach. The patient had a successful emergency transabdominal suture plication of the diaphragm and gastroplasty and has remained symptomless 3 months postoperatively.

scholarly journals The Giant Post-Traumatic Diaphragmatic Hernia: Clinical Case and Literature Review

2019 ◽  
Vol 8 (3) ◽  
pp. 325-331
Author(s):  
S. A. Domrachev ◽  
S. A. Kucher
Keyword(s):  
Abdominal Wall ◽  
Diaphragmatic Hernia ◽  
Reconstructive Surgery ◽  
Postoperative Period ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Diaphragmatic Rupture ◽  
Traumatic Diaphragmatic Hernia ◽  
Artificial Graft ◽  
Post Traumatic

The post-traumatic diaphragmatic hernia is a rare type of trauma which most commonly occurs after the blunt trauma of the thorax and abdomen. In the acute period of trauma, the symptoms of the emergency diseases and nonspecific signs of the diaphragmatic rupture are the reasons of frequent diagnostic mistakes. A missed diaphragmatic rupture grows in time and leads to migration of organs from the abdominal cavity to the thoracic one due to pressure gradient. The symptoms of diaphragmatic hernia are not expressed and the duration of the asymptomatic period of the disease may vary from some years to 10 years and longer. The increasing restructuring of the abdominal wall leads to reduced abdominal cavity, which makes the standard reconstructive surgery difficult, the intraabdominal pressure grows and relapse occurs in the postoperative period. In these cases, surgeons perform complex techniques which enlarge the abdominal cavity with local tissues or an artificial graft. However, there are no clear recommendations about the extent of the abdominal wall reconstruction so that the abdominal cavity size would be adequate for organs. The authors suggested a simple method to calculate it and used it in practice. In the article, we report the clinical case of a 53-year-old woman with a giant post-traumatic diaphragmatic hernia after motor vehicle accident 48 years ago and offer an original method of treatment. The first operation including hernia resolution and repair of diaphragmatic rupture was complicated by relapse on the second day after operation due to the high intra-abdominal pressure. During the second reconstructive surgery (4 months later), the authors performed their own method of abdominal cavity enlargement and got a good result in the shortand long-term postoperative period.

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