Features of diagnosis and treatment of false post-traumatic diaphragmatic hernias

Abstract

Damage to the diaphragm domes followed by the formation of false diaphragmatic hernias (FDH) occurs with closed and open trauma to the chest and/or abdomen. In this case, the mobile organs of the abdominal cavity, being uncovered by the parietal peritoneum, move to the pleural cavity and, with a small defect in the diaphragm, can be infringed up to necrosis of the organ wall. The rare occurrence of such pathology, the paucity of clinical symptoms, explains the high error rate in diagnosis, especially in primary health care. We have experience in two clinics over 34 years in the treatment of 12 patients with FDH. The left dome was damaged in 10 patients, the right dome in two. The age of damage to the diaphragm ranged from several hours to 7 years. Five clinical examples are presented, combined with the late diagnosis of the disease, the difficulties of diagnosis, even in a clinic using modern imaging tools. All patients are operated on both as planned and as an emergency. Endovideosurgical technologies for diagnosis and treatment are used only in 2 patients. 2 (16.67 %) patients died with a false diaphragmatic hernia due to a severe closed injury against the background of traumatic and hemorrhagic shocks. Conclusions. A clear explanation of the origin of scars on the skin of the chest and abdomen, clarification of the mechanisms and severity of closed injuries in the https://panor.ru/articles/osobennosti-diagnostiki-i-lecheniya-lozhnykh-posttravmaticheskikh-diafragmalnykh-gryzh/92437.html