ABSTRACT
Objectives: The aim of this study was to evaluate the surgical approach in post traumatic diaphragmatic hernia
Methods: This prospective cross-sectional study was conducted in the Department of cardiovascular and thoracic surgery, Sher-i- Kashmir Institute of Medical Sciences [SKIMS], Kashmir, India. We included all patients with post traumatic diaphragmatic hernia undergoing operation in our center from May 2009 to November 2011. A detailed history was taken for each patient along with comprehensive general, physical, systemic and local examination of all cases. Operative findings included associated intra-abdominal injuries, and herniated intra-abdominal organs. Post-operative complications, mortality and survival were recorded and reported
Results: The mean age of the patients was32+/-l years and there were 16 [76.1%] men and 5 [23.8%] women among the patients. Thoracotomy was performed in 14 patients [66.7%], laparotomy in 6 patients [28.6%] and combined procedure was used in 1 patient [4.7%]. The reduction of hernia contents with repair of diaphragmatic rent was done in 11 [52.2%] of the patients and splenectomy with repair of rent in 6 [28.6%]. Traumatic diaphragmatic hernia had 81.8% survival rate, no pre-operative mortality and 14.3% post operative mortality rate
Conclusion: Thoracotomy is the most common approach in post traumatic diaphragmatic hernia. Laparotomy is preferred in patients having acute trauma with associated intra-abdominal injuries