COLONIC OBSTRUCTION FOLLOWING DIRECT TRAU MATIC DIAPHRAGMATIC-HERNIA

We report two patients who were administered to our hospital with an o bstruction of the colon. 4 months ago one of the patients had suffered a penetrating wound with a knife in the upper left abdomen. The other patient was wounded by gunshot in the left thorax 50 years ago. The x -ray of the lung showed the ruptured diaphragm as a sharp line in the left thorax and the enema with contrast fluid revealed a stop at the l eft colonic flecture. In both cases the rupture of the diaphragm was c losed via an abdominal approach, the inspection of the colon did not d iscover any defect, The postoperative course was uneventful. In contra st to other authors we believe that the delayed rupture of the diaphra gm in connection with a colonic obstruction should be repaired by an a bdominal access.