The diagnosis and treatment of traumatic diaphragmatic hernia and diaphragmatic rupture

Objective: To explore the points of diagnosis and treatment of t raumatic diaphragmatic hernia and diaphragmatic rupture. Methods: A retrospectiv e study was carried out in 32 cases of traumatic diaphragmatic hernia and diaphr agmatic rupture treated surgically. In 18 of 32 cases (56.2%) diaphragma suffere d penetrating injury by sharp instrument, in 14(43.8%) suffered blunt injury. 18 cases occurred diaphragmatic rupture, 14 cases presented diaphragmatic hernia a nd 2 cases had Chronic diaphragmatic hernia among them. The types of damage due to different causes, their clinical signs as well as operative measures were ana lyzed. Results: For 32 cases, 13(40.6%) had been diagnosed as diaphragmatic rupt ure or diaphragmatic hernia preoperatively, 31(96.8%) were found diaphragmatic r upture and diaphragmatic hernia in the first operation and were repaired, 1(3.2% ) missed diagnosis, and 3(9.6%) died. Conclusions: Traumatic diaphragmatic rupt ure and diaph ragmatic hernia is a special type of multiple trauma with severe i njury and high mortality. The diagnosis should be based on the mechanism of trau ma and volume of bleeding. To choose proper operative approach and optimize the steps of treatment is important to increase the success rate of emergency tre atment.