Traumatic diaphragmatic hernia: Difference between revisions

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	Traumatic diaphragmatic hernia;
	An X-ray showing the spleen in the left lower portion of the chest cavity (X and arrow) after a diaphragmatic tear

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Latest revision as of 21:36, 11 February 2013

For patient information, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in-Chief: Awni D. Shahait, M.D.[2], The University of Jordan

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Traumatic Diaphragmatic Hernia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

Related Chapters

Diaphragmatic rupture

Template:WH Template:WikiDoc Sources

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+__NOTOC__
 {{Infobox_Disease |
    Name           = Traumatic diaphragmatic hernia |
    Image          = Diaphragmatic rupture spleen herniation.jpg |
-   Caption        = An [[X-ray]] showing the [[spleen]] in the left lower portion of the chest cavity (X and arrow) after a diaphragmatic tear<ref name="Hariharan06">{{cite journal |author=Hariharan D, Singhal R, Kinra S, Chilton A |title=Post traumatic intra thoracic spleen presenting with upper GI bleed! A case report |journal=BMC Gastroenterol |volume=6 |issue= |pages=38 |year=2006 |pmid=17132174 |pmc=1687187 |doi=10.1186/1471-230X-6-38 |url=http://www.biomedcentral.com/1471-230X/6/38}}</ref>|
+   Caption        = An [[X-ray]] showing the [[spleen]] in the left lower portion of the chest cavity (X and arrow) after a diaphragmatic tear|
-  DiseasesDB     = |
-  ICD10          = |
-  ICD9           = {{ICD9|862.0}} |
-  ICDO           = |
-  OMIM           = |
-  MedlinePlus    = |
-  eMedicineSubj  = med |
-  eMedicineTopic = 3487 |
-  MeshID         = D006549 |
 }}
-{{SI}}
+{{Traumatic diaphragmatic hernia}}
-{{CMG}}
+'''For patient information, click [[Traumatic diaphragmatic hernia (patient information)|here]]'''
-{{EH}}
+{{CMG}}; '''Associate Editor-in-Chief:''' [[User:AwniShahait|Awni D. Shahait, M.D.]][mailto:awnishahait@yahoo.com], The University of Jordan
-==Overview==
+==[[Traumatic diaphragmatic hernia overview|Overview]]==
-A '''traumatic diaphragmatic hernia''' is a type of [[diaphragmatic hernia]] which is acquired through an [[abdominal injury]]. This is in contrast to a [[congenital diaphragmatic hernia]], which is present from birth.
-Diaphragmatic injury accounts for 0.8-1.6% of blunt trauma abdomen. Approximately 4-6% of patients who undergo surgery for trauma have a diaphragmatic injury.<ref name="pmid3738439">{{cite journal |author=Ala-Kulju K, Verkkala K, Ketonen P, Harjola PT |title=Traumatic rupture of the right hemidiaphragm |journal=Scand J Thorac Cardiovasc Surg |volume=20 |issue=2 |pages=109–14 |year=1986 |pmid=3738439 |doi= |url=}}</ref>
+==[[Traumatic diaphragmatic hernia historical perspective|Historical Perspective]]==
-==Historical Perspective==
+==[[Traumatic diaphragmatic hernia pathophysiology|Pathophysiology]]==
-Traumatic diaphragmatic hernia apparently was described by Sennertus, who in 1541 reported an instance of delayed herniation of viscera through an injured diaphragm.<ref name="pmid8526655">{{cite journal |author=Shah R, Sabanathan S, Mearns AJ, Choudhury AK |title=Traumatic rupture of diaphragm |journal=Ann. Thorac. Surg. |volume=60 |issue=5 |pages=1444–9 |year=1995 |month=November |pmid=8526655 |doi=10.1016/0003-4975(95)00629-Y |url=}}</ref> Ambroise Paré, in 1579, described the first case of diaphragmatic rupture diagnosed at autopsy. The first successful diaphragmatic repair was reported by Riolfi in 1886 in a patient with omental prolapse, and Naumann in 1888 repaired the defect with herniated stomach.
-==Pathophysiology==
+==[[Traumatic diaphragmatic hernia causes|Causes]]==
-Diaphragmatic injuries are caused either by penetrating or blunt injuries to the abdomen. They are diagnosed immediately as part of multi-organ injury, or present later either with respiratory distress or as intestinal obstruction.<ref name="pmid14799666">{{cite journal |author=CARTER BN, GIUSEFFI J, FELSON B |title=Traumatic diaphragmatic hernia |journal=Am J Roentgenol Radium Ther |volume=65 |issue=1 |pages=56–72 |year=1951 |month=January |pmid=14799666 |doi= |url=}}</ref> The mechanism in blunt injury is explained by shearing of a stretched membrane, avulsion at the point of diaphragmatic attachment, and the sudden force transmission through viscera acting as viscous fluid. Left sided injuries are more often seen. Left-sided rupture occurred in 68.5% of the patients, 24.2% had right-sided rupture, 1.5% had bilateral rupture, 0.9% had pericardial rupture, and 4.9% were unclassified.<ref name="pmid3738439">{{cite journal |author=Ala-Kulju K, Verkkala K, Ketonen P, Harjola PT |title=Traumatic rupture of the right hemidiaphragm |journal=Scand J Thorac Cardiovasc Surg |volume=20 |issue=2 |pages=109–14 |year=1986 |pmid=3738439 |doi= |url=}}</ref> Increased strength of the right hemi-diaphragm, hepatic protection of the right side, under diagnosis of right-sided ruptures, and weakness of the left hemi-diaphragm at points of embryonic fusion all have been proposed to explain the predominance of left sided diaphragmatic injuries.<ref name="pmid3738439">{{cite journal |author=Ala-Kulju K, Verkkala K, Ketonen P, Harjola PT |title=Traumatic rupture of the right hemidiaphragm |journal=Scand J Thorac Cardiovasc Surg |volume=20 |issue=2 |pages=109–14 |year=1986 |pmid=3738439 |doi= |url=}}</ref> Autopsy studies reveals that the incidence of rupture is almost equal on both sides but the greater force needed for the right rupture. A positive pressure gradient of 7-20 cms of H2O between the intraperitoneal and the intra pleural cavities forces the contents into the thorax. With severe blunt trauma the pressures may rise to as high as 100cms of water.
-It can occur after [[splenectomy]].<ref name="pmid18368327">{{cite journal |author=Tsuboi K, Omura N, Kashiwagi H, Kawasaki N, Suzuki Y, Yanaga K |title=Delayed traumatic diaphragmatic hernia after open splenectomy: report of a case |journal=Surg. Today |volume=38 |issue=4 |pages=352–4 |year=2008 |pmid=18368327 |doi=10.1007/s00595-007-3627-0 |url=http://dx.doi.org/10.1007/s00595-007-3627-0}}</ref>
+==[[Traumatic diaphragmatic hernia differential diagnosis|Differentiating Traumatic Diaphragmatic Hernia from other Diseases]]==
-Because it can be indicative of severe trauma, it often co-presents with [[pelvic fracture]].<ref name="pmid8257229">{{cite journal |author=Meyers BF, McCabe CJ |title=Traumatic diaphragmatic hernia. Occult marker of serious injury |journal=Ann. Surg. |volume=218 |issue=6 |pages=783–90 |year=1993 |month=December |pmid=8257229 |pmc=1243075 |doi= |url=}}</ref>
+==[[Traumatic diaphragmatic hernia epidemiology and demographics|Epidemiology and Demographics]]==
-==Diagnosis==
+==[[Traumatic diaphragmatic hernia risk factors|Risk Factors]]==
-==Differential Diagnosis==
+==[[Traumatic diaphragmatic hernia natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
-==Complications==
+==Diagnosis==
+[[Traumatic diaphragmatic hernia history and symptoms|History and Symptoms]] | [[Traumatic diaphragmatic hernia physical examination|Physical Examination]] | [[Traumatic diaphragmatic hernia laboratory findings|Laboratory Findings]] | [[Traumatic diaphragmatic hernia chest x ray|Chest X Ray]] | [[Traumatic diaphragmatic hernia CT|CT]] | [[Traumatic diaphragmatic hernia MRI|MRI]] | [[Traumatic diaphragmatic hernia ultrasound|Ultrasound]] | [[Traumatic diaphragmatic hernia other imaging findings|Other Imaging Findings]] | [[Traumatic diaphragmatic hernia other diagnostic studies|Other Diagnostic Studies]]
 ==Treatment==
+[[Traumatic diaphragmatic hernia medical therapy|Medical Therapy]] | [[Traumatic diaphragmatic hernia surgery|Surgery]] | [[Traumatic diaphragmatic hernia primary prevention|Primary Prevention]] | [[Traumatic diaphragmatic hernia secondary prevention|Secondary Prevention]] | [[Traumatic diaphragmatic hernia cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Traumatic diaphragmatic hernia future or investigational therapies|Future or Investigational Therapies]]
-==Prognosis==
+== Case Studies ==
+[[Traumatic diaphragmatic hernia case study one|Case #1]]
-==See also==
+==Related Chapters==
 *[[Diaphragmatic rupture]]
-==References==
-{{reflist}}
-{{Injuries, other than fractures, dislocations, sprains and strains}}
-{{SIB}}
 [[Category:Emergency medicine]]
 [[Category:Pulmonology]]
+[[Category:Disease]]
 {{WH}}
 {{WikiDoc Sources}}


Traumatic diaphragmatic hernia
An X-ray showing the spleen in the left lower portion of the chest cavity (X and arrow) after a diaphragmatic tear

Traumatic diaphragmatic hernia: Difference between revisions

Latest revision as of 21:36, 11 February 2013

Diagnosis

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