[Two cases of traumatic-diaphragmatic hernia].

Abstract

We report two cases of traumatic-diaphragmatic hernia caused by blunt injury. In case 1, abdominal findings were discovered on the 2nd day after the patient fell on the bottom from a horse, and in case 2, an emergency laparotomy was carried out due to the respiratory dysfunction which appeared immediately after a labor injury. The diaphragmatic ruptures at the left side observed in both cases, were closed directly. The prolapsed organs which shifted into the thoracic cavity were the stomach and colon in case 1, and the spleen and the tail part of the pancreas in case 2. In both cases, the organs were easily repositioned into the abdominal cavity without a hernial sac, but a splenectomy had to be performed because of splenic lacerations. In case 2, right rib fractures and lacerations of the left adrenal gland with retroperitoneal hematoma were observed. In the case of thoraco-abdominal blunt injuries, it is important to perform an early diagnosis and to consider the possibility of diaphragmatic hernia.