Abstract

Traumatic diaphragmatic hernia is potentially life-threatening due to the sudden protrusion of abdominal organs into the pleural cavities due to the pressure wave or the dynamic force caused by the BLUNT Compression .This kind of Blunt trauma may be overlooked easily and a misdiagnosis of some other minor trauma may be considered as Pivotal and attention seeking However a high index of suspicion is essential during the primary survey itself. Material and Methods: A clinical study of 60 patients is conducted with a diagnosis of Traumatic Diaphragmatic Hernia Results; >60 years of age group is the most affected Male gender is the most common affected. Left side is the most common side affected. In 53 cases BLUNT injury was the cause . In 7 patients penetrating injury was the cause. Out of 60 patients 51 patients had acute presentation with associated injuries. 9 patients had delayed presentation after various period of time after the conservative management during the admission and discharge from the hospital, All the 7 patients with penetrating injuries had Emergency Laparotomies and the appropriate treatment for the traumatic diaphragmatic rupture 44 of the Blunt injuries also had an EEL and the appropriate treatment of the diaphragmatic rupture and of the associated injuries. 9 with delayed presentations had total conservative management and hence the tiny rents in the diaphragm without any abdominal organ herniation had delayed presentations at a later date after discharge from the hospital. 2 case succumbed to death after the emergency management one due to the respiratory failure and the other one due to the hollow viscus perforation followed by sepsis. Conclusions; Morbidity and mortality associated with diaphragmatic rupture is predominantly due to the associated injuries and hence due to the injury severity Score during the Primary and Secondary Survey. Comorbidities of any kind and low immune status are contributory to the morbidity and mortality.

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