• Journal of Chest Surgery
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• v.26 no.2
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• pp.96-101
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• 1993

Fourteen cases of diaphragmatic hernias surgically treated at the Dept. of Thoracic ＆ Cardiovascular Surgery in Kosin Medical Center from Jan. 1979 to Feb. 1991, were reviewed in this study. This report includ 9 cases of traumatic diaphragmatic hernia, 5 cases of congenital diaphragmatic hernia. Among the traumatic hernias, 5 cases were blunt trauma and 4 cases were penetrating trauma. Five cases of congenital diaphragmatic hernias were presented, including 2 cases of esophageal hiatal hernia, 2 cases of Bochdalek's hernia and a case of Morgagni's hernia. Operation was performed in all patients. Results of all treated cases were excellent.

• Journal of Trauma and Injury
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• v.32 no.1
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• pp.66-70
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• 2019

Traumatic diaphragmatic injuries (TDIs) are a rare complication in thoraco-abdominal trauma. The diagnosis is difficult and if left untreated, TDI can cause traumatic diaphragmatic hernia (TDH). Through an injured diaphragm, the liver, spleen, stomach, small intestine, and large intestine can be herniated to the thoracic cavity, but pancreatic herniation and pancreatitis are quite rare in TDH. This paper reports a case of pancreatitis developed by additional trauma in a patient with asymptomatic chronic TDH. A 58-year-old male visited the emergency department with a left abdominal injury after a fall 6 hours earlier. The vital signs were stable, but the amylase and lipase levels were elevated to 558 U/L and 1,664 U/L, respectively. Abdominal computed tomography (CT) revealed a left diaphragmatic hernia and an incarceration of the stomach, pancreatic ductal dilatation, and peripancreatic fatty infiltration. Additional history taking showed that he had suffered a fall approximately 20 years ago and had an accidentally diaphragmatic hernia through a chest CT 6 months earlier. A comparison with the previous CT revealed the pancreatitis to be caused by secondary pancreatic ductal obstruction due to the incarcerated stomach. For pancreatitis, gastrointestinal decompression was performed, and after 3 days, the pancreatic enzyme was normalized; hence, a thoracotomy was performed. A small ruptured diaphragm was found and reposition of the organs was performed. This paper reports the experience of successfully treating pancreatitis and pancreatic hernia developed after trauma without complications through a thoracotomy following gastrointestinal decompression.

• Journal of Chest Surgery
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• v.28 no.9
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• pp.837-841
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• 1995

Between June 1981 and April 1994, 15 patients underwent surgical repair of diaphragmatic hernia. The ages ranged from 1 day to 60 years, with a mean age of 34. There were 5 cases of congenital diaphragmatic hernia; Bochdalek hernia in 4 cases and Morgagni hernia in 1 case. There were 10 cases of traumatic diaphragmatic hernia;blunt trauma in 8 cases and stab wounds in 2 cases. The chest X-ray findings were abnormal in 10 cases. Operations were performed in all patients and there was only one death, who was a newborn with left Bochdalek hernia and pulmonary hypoplasia.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.328-335
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• 1976

This case report included 4 cases of traumatic diaphragmatic hernias, 3 cases of non-traumatic diaphragmatic hernias, and 3 cases of eventration of the diaphragm. Among the traumatic hernias, one case was in immediate phase of traumatic diaphragmatic rupture by traffic accident, 2 cases were in intermediate phase with chronic respiratory or vague gastrointestinal symptoms after traffic accident, and the other was developed after an operation, decortication for a chronic empyema with severe pleural calcifications, damaging the diaphragm. Three cases of nontraumatic diaphragmatic hernia were presented, including 2 cases of probable Bochadlek's hernia (Parents refused operation) and a case of Morgagni's hernia with severe gastrointestinal symptoms. And three cases of eventration of the diaphragm with symptoms were also reported. Results of all treated cases were excellent.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.56-59
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• 2023

Traumatic diaphragmatic hernia is among the most uncommon conditions after severe trauma, and it is associated with high morbidity and mortality. The diagnosis is difficult and might be missed, but a multimodal investigation might help in terms of diagnostic yield. In this case report, we present a missed right diaphragmatic rupture 14 years after the trauma.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.298-300
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• 2010

Diaphragmatic paralysis can be demonstrated through diaphragmatic elevation on chest X-ray after thoracic lung surgery or the placement of chest tubing. Additional causes of diaphragmatic paralysis are iatrogenic, mass, atelectasis, etc. For the diagnosis of diaphragmatic paralysis, it required some studies (fluoroscopy, computed tomography [CT], magnetic resonance imaging). Diaphragmatic hernia of the liver is a rare clinical entity, usually found after trauma in adults. Congenital diaphragmatic hernia in neonates requires surgery. Non-traumatic diaphragmatic hernia of the liver in an adult is a rare right-sided diaphragmatic hernia. On developing any symptoms, surgery must be performed. When diaphragmatic hernia is incidentally found in adults without trauma, it is placed under observation for a time period. We diagnosed the diaphragmatic herniation of a right hepatic lobe by 16-slice CT scan without surgery.

• Journal of Veterinary Clinics
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• v.26 no.1
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• pp.62-68
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• 2009

A diaphragm is a musculotendinous partition that separates abdominal and thoracic organs and assists in ventilation. Three dogs were presented after being hit by a car, and one dog was presented with the history of respiratory problems including intermittent dyspnea and coughing. Survey thoracic radiography, positive contrast celiography and sonography revealed traumatic diaphragmatic hernia in three dogs and congenital peritoneopericardial diaphragmatic hernia in one dog. In three dogs including a dog with congenital peritoneopericardial diaphragmatic hernia, herniorrhaphy was performed. Among the three dogs underwent surgery, two dogs with traumatic diaphragmatic hernia recovered uneventfully. However the dog with congenital peritoneopericardial diaphragmatic hernia died from pulmonary edema at 2 days after surgery. Positive-contrast ceilography and ultrasonography provides to investigate the integrity of the diaphragm. Chronic diaphragmatic hernia and concurrent injuries are considered as prognostic factors.

• Journal of Chest Surgery
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• v.6 no.2
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• pp.237-242
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• 1973

Two cases of traumatic diaphragmatic hernia are reported, who were operated on in this department during the last 12 months` period. The first case, a 34 year old male, fell from 6 meters` height while he was working on electric pole. He sustained rib fractures, left 8th, 9th and 10th rib, left diaphragmatic rupture and ileal perforation. In the pleural cavity, there were stomach, omentum, left lobe of liver, transverse colon and ileum, which were reduced into the peritoneal cavity, and the diaphragmatic aperture was closed through anterolateral thoracotomy. After closure of the thoracic incision, median abdominal incision was made and closed the ileal perforation by primary suture. The second case was a 19 year old tyre repairman, who felt abrupt severe abdominal pain during lifting a heavy lyre. A barium study revealed a marked displacement of the stomach into the left pleural cavity. Immediately, thoracotomy was performed and closed the ruptured diaphragm after reduction of the herniated stomach, omentum, transverse colon, spleen and small intestine. The size of the diaphragmatic aperture were measured 17cm. in first case and 12cm. in the other respectively. Both cases discharged after uneventful recovery.

• Journal of Chest Surgery
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• v.11 no.4
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• pp.433-440
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• 1978

Congenital diaphragmatic hernia is an important cause of respiratory distress in the newborn. Eventration, with which these conditions are easily confused, may also Produce severe respiratory distress in infancy or be an asymptomatic radiographic finding. Harrington`s classification of diaphragmatic hernias into two categories, traumatic and nontraumatic, is most widely accepted. Nontraumatic hernias are [1] the congenital types, composed of the posterolateral [Bochdalek], those through the esophageal hiatus, the parasternal [/Morgagni], and those through a defect left by partial absense posteriorly, and [2] the acquired types, composed of those through the esophagea/hiatus [sliding and paraesophageal] and those the sites mentioned above under the congenital hernias. During the period from 1970 up to October 1978, 21 cases of diaphragmatic hernia were treated in department of cardiovascular and thoracic surgery. 11 cases of Bochdalek hernias, 1 case of Morgagni hernia, 5 cases of diaphragmatic eventration and 3 cases of hiatal hernia [2 cases of paraesophageal and 1 cases of sliding type], were experienced. 3 cases of 20 died of respiratory insufficiency, 2 cases of mortality were combined with left lung hypoplasia with Bochdalek hernia.

• Journal of Chest Surgery
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• v.2 no.1
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• pp.59-64
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• 1969

Three cases of traumatic diaphragmatic hernia were repaired in this department from June 1967 to Nov.1968. The first case, a 14 year old girl, was diagnosed as diaphragmatic hernia during the operation of the diffuse peritonitis from jejunaI perforation 3 days after the traffic accident at local clinic and she was transfered to this hospital after the closure of the perforated jejunum. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture at the posterolateral portion of the left diaphragm was repaired with two layer sutures by transthoracic approach. The second case. a 26 year old man. was diagnosed immediately after the traffic accident at local clinic and transfered to this hospital 24 hours later. Herniated and distended stomach, transverse colon and jejunum were repositioned and the large diaphragmatic rupture, about 9 cm in length, from the posterolateral portion to the base of the pericardium was directly repaired with two layer sutures. The third case, a 26 year old man, who had a history of stab wound at left lower lateral chest two years ago,was admitted with the sudden onset of abdominal pain and vomiting. The diaphragmatic hernia was confirmed with barium enema. The herniated stomach and transverse colon through the defect, about 3.5 cm in diameter, at anterolateral portion of the left diaphragm, were repositioned and the defect was repaired with two layer sutures. All of the cases recovered uneventfully.