Farooq Ahmad Ganie; Ghulam Nabi Lone; Mushtaq Ahmed Chowdhary; Hafzulla lone
Volume 1, Issue 3 , July 2013, , Pages 108-111
Abstract
Objectives: The aim of this study was to evaluate the surgical approach in post traumatic diaphragmatic hernia.Methods: This prospective cross-sectional study was conducted in the Department of cardiovascular and thoracic surgery, Sher-i- Kashmir Institute of Medical Sciences (SKIMS), Kashmir, India. ...
Read More
Objectives: The aim of this study was to evaluate the surgical approach in post traumatic diaphragmatic hernia.Methods: This prospective cross-sectional study was conducted in the Department of cardiovascular and thoracic surgery, Sher-i- Kashmir Institute of Medical Sciences (SKIMS), Kashmir, India. We included all patients with post traumatic diaphragmatic hernia undergoing operation in our center from May 2009 to November 2011. A detailed history was taken for each patient along with comprehensive general, physical, systemic and local examination of all cases. Operative findings included associated intra-abdominal injuries, and herniated intra-abdominal organs. Post-operative complications, mortality and survival were recorded and reported.Results: The mean age of the patients was 32±1 years and there were 16 (76.1%) men and 5 (23.8%) women among the patients. Thoracotomy was performed in 14 patients (66.7%), laparotomy in 6 patients (28.6%) and combined procedure was used in 1 patient (4.7%). The reduction of hernia contents with repair of diaphragmatic rent was done in 11 (52.2%) of the patients and splenectomy with repair of rent in 6 (28.6%). Traumatic diaphragmatic hernia had 81.8% survival rate, no pre-operative mortality and 14.3% post operative mortality rate.Conclusion: Thoracotomy is the most common approach in post traumatic diaphragmatic hernia. Laparotomy is preferred in patients having acute trauma with associated intra-abdominal injuries.
Farooq Ahmad Gaine; Ghulam Nabi Lone; Mushtaq Ahmad Chowdhary; Hafeezula Lone
Volume 1, Issue 2 , April 2013, , Pages 76-80
Abstract
Objectives: The aim of this study was to evaluate the etiology, associated injurers and clinical presentation of post traumatic diaphragmatic hernia.Methods: This study was a cross-sectional study being conducted in the department of Cardiovascular, thoracic surgery (CVTS) and Pediatric Surgery, Sher-i-Kashmir ...
Read More
Objectives: The aim of this study was to evaluate the etiology, associated injurers and clinical presentation of post traumatic diaphragmatic hernia.Methods: This study was a cross-sectional study being conducted in the department of Cardiovascular, thoracic surgery (CVTS) and Pediatric Surgery, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Kashmir, India. All patients of post traumatic diaphragmatic hernia who were admitted in the department of CVTS and Pediatric Surgery, SKIMS, during the course of study (May 2009 to Nov. 2011) were included.Results: From the commencement of the study 21 patients had traumatic diaphragmatic hernia. Most common presenting symptoms in traumatic diaphragmatic hernia were, chest discomfort and pain abdomen presented in 81% of patients, followed by breathlessness in 61.9% and vomiting in 47.6%. Common associated injuries in traumatic diaphragmatic hernia in our study group were, rib fracture in 47.6%, splenic injury in 28.6%, head injury in 23.8%, soft tissue injury in 23.8%, gut perforation in 19%, limb fracture in 14.3%, liver injury in 9.5%, pancreatic injury in 4.8% and renal injury in 4.8%.Conclusion: Usually the patients of Post traumatic diaphragmatic hernia presents as emergency, early recognition and prompt surgical treatment is needed for better outcome. The Incidence of post traumatic diaphragmatic hernia when associated with blunt trauma abdomen and chest is very high (81%). A high level of suspicion is needed in these injuries. The 9.5% of traumatic diaphragmatic hernia may have delayed presentation. Early diagnosis of traumatic diaphragmatic hernia is most difficult when herniation is delayed.
Farooq Ahmad Ganie; Hafeezulla Lone; Ghulam Nabi Lone; Mohd Lateef Wani; Shyam Singh; Abdual Majeed Dar; Nasir-u-din Wani; Shadab nabi wani; Nadeem-ul Nazeer
Volume 1, Issue 1 , January 2013, , Pages 7-16
Abstract
Lung contusion is an entity involving injury to the alveolar capillaries, without any tear or cut in the lung tissue. This results in accumulation of blood and other fluids within the lung tissue. The excess fluid interferes with gas exchange leading to hypoxia. The pathophysiology of lung contusion ...
Read More
Lung contusion is an entity involving injury to the alveolar capillaries, without any tear or cut in the lung tissue. This results in accumulation of blood and other fluids within the lung tissue. The excess fluid interferes with gas exchange leading to hypoxia. The pathophysiology of lung contusion includes ventilation/perfusion mismatching, increased intrapulmonary shunting, increased lung water, segmental lung damage, and a loss of compliance. Clinically, patient’s presents with hypoxiemia, hypercarbia and increase in laboured breathing. Patients are treated with supplemental oxygen and mechanical ventilation whenever indicated. Treatment is primarily supportive. Computed tomography (CT) is very sensitive for diagnosing pulmonary contusion. Pulmonary contusion occurs in 25–35% of all blunt chest traumas.
