Watchful questions on diagnosis and treatment of traumatic diaphragmatic rupture and diaphragmatic hernia

Objective To explore the clinical characteristics and the treatments on traumatic diaphragmatic rupture and diaphragmatic hernia.Method A retrospective study was carried out in 49 cases of traumatic diaphragmatic rupture and diaphragmatic hernia.Results There were 32 cases with left diaphragmatic hernia,13 cases with right diaphragmatic hernia and 4 cases with bilateral diaphragmatic hernia.One case with closed combined thoraco-abdominal wound and shock,died of multiple organ failure after the surgery,3 cases were diagnosed more than 24 h after injury,the others closed injury patients were diagnosed within 24 h and cured.In patients with open diaphragmatic rupture and diaphragmatic hernia,16 cases underwent laparotomy surgery,5 cases of misdiagnosis experienced re-thoracotomy,7 cases thoracotomy,2 cases changed the thoraco-abdominal surgery.Three cases underwent thoraco-abdominal surgery.Twenty-five cases were cured; 1 patient with suppurative costal chondritis,duration up to 13months.Conclusion Traumatic diaphragmatic rupture and diaphragmatic hernia is easily missed and misdiagnosed,the establish of rational examination preoperatively can reduce complications,misdiagnosis and mortality. Key words: Hernia,diaphragmatic,traumatic; Diagnosis; Therapy