The Etiology, Associated Injuries and surgical management of Post Traumatic Diaphragmatic Hernia; A retrospective study

Abstract

Background: Due to increasing urbanization and mechanization of lifestyle incidence of road traffic accidents has increased. Because of these road traffic accidents the incidence of traumatic diaphragmatic injuries also increases. Our study was to evaluate retrospectively the etiology, associated injuries, and surgical management of blunt diaphragmatic injuries. Methods: This retrospective case study was conducted from January 2016 to January 2019 jointly by Thoracic surgery ward Medical Teaching Institute LRH Peshawar Pakistan and Medical Teaching Institute Hayatabad Medical Complex Peshawar Pakistan. Patients of any age and either sex with diaphragmatic injury post blunt trauma received in emergency or OPD or shifted from other ward were included in the study. Patients with penetrating diaphragmatic injuries and congenital diaphragmatic hernias were excluded from the study. All the clinical presentations, demographic data, baseline investigations, and specific investigations were recorded on a pro forma and analyzed. Results: Thirty-Five patients were included in our study, Out of these 35 patients 24 patients presented to the emergency department, 07 patients presented late to our OPD with a history of trauma, and four patients were shifted to us from other wards. The age range in our study was from 07 years to 62 years. Most of the patients were in the age group of 18-48 years (68.9%). Male were 24(68.57%) and female 11(31.42%). Thirty-one patients had a left-sided injury and 4 patients had right-sided. Out of 35 patients, 21 had road traffic accidents. Seven patients who came to OPD were diagnosed delayed. Morbidity was 3 (8.57%). There was no mortality in our study Conclusion: Urbanization and mechanization have increased the incidence of road traffic accidents and increase diaphragmatic injuries as evident from our study. Early diagnosis and surgical repair have got good results. Keywords: Blunt trauma; Diaphragmatic injury; Urbanization