Research

Diaphragmatic hernia in children following blunt trauma abdomen: our experiences and lessons learned.

Vaibhav Pandey, Pranay Panigrahi, Rakesh Kumar and Vivek Srivastav
World Journal of Surgical Research 2017, 6:7

Abstract

Introduction

Acquired diaphragmatic hernias are rare, life-threatening clinical conditions occurring after an abrupt increase of intra-abdominal pressure. We present our experience with post traumatic diaphragmatic hernia in children following blunt abdominal trauma.

Material and methods 

This retrospective study was conducted in the Department of Paediatric surgery and Level I pediatric trauma centre of northern India. All the patients with suspected diaphragmatic hernia following blunt abdominal trauma admitted in the department of paediatric surgery and trauma centre between April 2011 and March 2017 were included in the study. The case records were used to collect the data.

Results 

Total seven cases of were suspected to have post traumatic diaphragmatic hernia out of 142 patients managed during the study period. Out of these, three were cases of congenital asymptomatic eventration of diaphragm. Four cases were of post traumatic diaphragmatic hernia, three on left side and one on right side. Mode of injury was fall from height in all cases with a mean age of 4.54±1.44 years. All cases hemodynamically stable had abdominal distension and respiratory distress at time of presentation. Contrast enhanced computed tomography showed, diaphragmatic defect in all the patients. All four patients were operated after initial resuscitation.

Conclusion

Acquired diaphragmatic hernia is a rare entity in children following blunt abdominal trauma and a very high index of suspicion should be there to rule out congenital asymptomatic eventration of diaphragm in order to avoid unnecessary laparotomies.

Key words

abdominal trauma, liver atrophy, Post traumatic diaphragmatic hernia, right diaphragmatic hernia

Download PDF    Full Text