the characteristics and surgical approach in post-traumatic diaphragmatic hernia: a single center experience

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 was 32±1 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.