СОВРЕМЕННЫЕ ВЗГЛЯДЫ НА ДИАГНОСТИКУ РАНЕНИЙ ДИАФРАГМЫ ПРИ ТОРАКОАБДОМИНАЛЬНЫХ РАНЕНИЯХ

An extremely severe complication of thoracoabdominal wounds is formation of diaphragmatic hernia with possible entrapment of abdominal organs as result of undiagnosed diaphragmatic injuries. Objective – to research the modern state of the problem of identification of diaphragmatic injuries in patients with thoracoabdominal injuries, to determine the directions for improvement in diagnosis of this pathology. Materials and methods. The analysis included the data on diagnosis of diaphragmatic injuries in patients with thoracoabdominal injuries in the domestic and foreign literature over the last 5 years. Results. The researchers note that presurgical diagnosis of diaphragmatic injuries is quite difficult. They recommend wider usage of low invasive surgical techniques. Many authors review the thoracoabdominal region as the field for determination of indications. A location of a wound in the thoracoabdominal region results in high possibility of a diaphragmatic injury and requires for obligatory examination of the diaphragm. However the authors interpret various boundaries of this region. So, the researchers have different opinions on visualizing the diaphragm defect and prefer laparoscopy, thoracoscopy and minithoracotomy. Conclusion. Different authors’ opinions on boundaries of the thoracoabdominal region and absence of the uniform approach to invasive techniques in diagnosis of diaphragmatic injuries show the necessity for further researchers for clarification of the boundaries of the thoracoabdominal region and development of the algorithm for invasive diagnosis of diaphragmatic injuries.