DIAPHRAGMATIC HERNIATION AFTER PENETRATING TRAUMA

A study was made of 45 patients with diaphragmatic herniation after pe netrating trauma. In 29 the diagnosis was established during the first admission (early presentation) and in 16 during a subsequent admissio n (delayed presentation). The mortality rate in the early presentation group was 3 per cent compared with 25 per cent in the delayed present ation group. The presence of gangrenous or perforated abdominal viscus in the chest cavity was the single most common and severe aggravating factor. The need for diagnosis of diaphragmatic herniation during the initial admission is emphasized. As isolated diaphragmatic injuries p rovided few helpful clinical feature to aid diagnosis, appropriate inv estigations and good follow-up are of paramount importance in preventi ng late herniation of intra-abdominal viscera through a penetrating di aphragmatic injury.