Characteristics of the clinical picture, diagnosis and treatment of strangulated post-traumatic diaphragmatic hernia (clinical observations)
Abstract
The authors present their own clinical observations of
successful surgical treatment of 2 patients with a pinched posttraumatic
diaphragmatic hernia. In both cases, patients were referred to the hospital with a
diagnosis of "chronic pancreatitis". The most informative and
accurate method of diagnosis was computed tomography of the chest and abdominal
organs. The removal of pinched posttraumatic diaphragmatic hernias was
performed laparoscopically. The article emphasizes that the clinical
picture of impaired posttraumatic diaphragmatic hernias may correspond to that of
other acute diseases of the abdominal cavity, which complicates the diagnostic
process. The laparoscopic method of surgical treatment is less traumatic
and in most cases can be the operation of choice. Timely diagnosis and
emergency surgical treatment directly affect the course of
the postoperative period and the outcome of the disease.
Keywords:pinched diaphragmatic hernia, necrosis, computed tomography, laparoscopic surgery
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Ivanov Yu.V., Epifantsev E.A., Lysenko A.O., Stankevich V.R., Smirnov A.V.,
Zlobin A.I., Akhmedyanov A.R., Gritsun V.Yu., Velichko E.A. Characteristics of
the clinical picture, diagnosis and treatment of strangulated
post-traumatic diaphragmatic hernia (clinical observations). Clinical and
Experimental Surgery. Petrovsky Journal. 2021; 9 (3): 143-9. DOI: https://doi.org/10.33029/2308-1198-2021-9-3-143-149 (in Russian)
References
1. Domrachev S.A., Kucher S.A. Giant post-traumatic diaphragmatic hernia: a clinical case and review of the literature. Neotlozhnaya meditsinskaya pomoshch’. Zhur-nal im. N.V. Sklifosovskogo [Emergency Health Care. The journal named after N.V. Sklifosovsky]. 2019; 8 (3): 32531. DOI: https://doi.org/10.23934/2223-9022-2019-8-3-325-331 (in Russian)
2. Testini M., Girardi A., Isernia R., De Palma A., Catalano G., Pezzolla A., Gurrado A. Emergency surgery due to diaphragmatic hernia: case series and review. World J Emerg Surg. 2017; 18 (12): 23. DOI: https://doi.org/10.1186/s13017-017-0134-5
3. Chikinev Yu.V., Drobyazgin E.A. Posttraumatic diaphragmatic hernias (diagnosis and treatment). Acta Biomedica Scientifica (Vostochno-Sibirskiy biomeditsin-skiy zhurnal) [Acta Biomedica Scientifica (East Siberian Biomedical Journal)]. 2017; 2 (6): 163-6. DOI: https://doi.org/10.12737/article_5a0a8e9d1eae15.34300032 (in Russian)
4. Lu J., Wang B., Che X., Li X., Qiu G., He S., et al. Delayed traumatic diaphragmatic hernia: A case-series report and literature review. Medicine (Baltimore). 2016; 95 (32): e4362. DOI: https://doi.org/10.1097/MD.0000000000004362
5. Parshin V.D., Hetagurov M.A. Diaphragmatic hernias in elective thoracic surgery. Khirurgiya. Zhurnal imeni N.I. Pirogova. [Surgery. The Journal Named after N.I. Pirogov]. 2018; (8): 36-45. DOI: https://doi.org/10.17116/hirurgia2018836 (in Russian)
6. Lee J., Han K., Hong J., Kim H. A single-port video-assisted thoracoscopic surgery with CO2 insufflation for traumatic diaphragmatic hernia. Interact Cardiovasc Thorac Surg. 2019; 29 (5): 808-10. DOI: https://doi.org/10.1093/icvts/ivz173
7. Silva G., Cataneo D., Cataneo A. Thoracotomy compared to laparotomy in the traumatic diaphragmatic hernia. Systematic review and proportional methanalysis. Acta Cir Bras. 2018; 33 (1): 49-66. DOI: https://doi.org/10.1590/s0102-865020180010000006