Diaphragmatic injury and management: our experience over 99 months at a tertiary care centre

Author: 
Dheer S. Kalwaniya, Akshay Narayan, Satya V. Arya, Jaspreet S. Bajwa, Monish R, Rohit C, Nipun S and Ashok K

Background:-Road traffic accidents have emerged as a major cause of morbidity and mortality since the advent of motorised vehicles due to industrialisation and thoraco-abdominal trauma contributes to this morbidity and mortality in a great way. When missed during primary evaluation, the diaphragmatic hernias can have late presentation, that may range from mild respiratory discomfort or intestinal obstruction to strangulation of bowel presenting drastically. Our aim in this study is toanalyse and review the experience in the presentation, diagnosis and management of diaphragmatic hernia with postoperative outcomes.
Methods: This study was a retrospective observational study conducted at a tertiary care hospital of New Delhi. In this study, the data of patients with thoracic trauma attending the surgical unit from May 2011 to March 2019 have been collected for analysis. A total of 1576 patients of thoracic trauma patients were treated at our centre of which 19 (1.2%) were diagnosed to have diaphragmatic hernia and underwent surgery for the same.
Results: Post-operative complications were higher in case of patients who were present to the hospital after the 24 hours of trauma (63.6%) compare to the patients who attend the hospital within 24 hours (37.5%). It was noticed that patients, had associated injury (58.3%) other than diaphragmatic hernia were prone to more postoperative complications compare to patients who had not (42.9%).
Conclusion: Present study revealed that in time hospitalization, early diagnosis and management of thoracoabdominal trauma patients is a keyfactor for better post operative outcomes as well as to prevent further complications related to trauma and surgery.

Download PDF: 
DOI: 
http://dx.doi.org/10.24327/ijcar.2019.20260.3951
Select Volume: 
Volume10