Thirteen Years' Experience of Diaphragmatic Injury in Children from the Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, India.
2011
Background: Diaphragmatic hernia is migration of abdominal viscera into
the thoracic cavity through a defect in the diaphragm. In children, it
is mostly congenital; traumatic diaphragmatic hernia being less common.
This study aimed to review our experience with traumatic diaphragmatic
rupture (TDR) and to identify the clinical findings and diagnostic
modality that may help in early diagnosis and prompt therapy. Methods:
The study involved 11 children (1-18 years old) with TDR who were
hospitalised between 1993 and 2005. In addition to clinical
examination, a plain X-ray of the chest and abdomen, an ultrasound,
barium studies, and a computerised tomography (CT) scan were used to
evaluate the patients. Results: All of the diaphragmatic ruptures
occurred on the left side, with 10 occurring in the posterolateral part
and 1 near the oesophageal hiatus. Two of our patients presented 7 and
10 days after the injury, and 1 patient presented 1 year after the
trauma. Conclusion: TDR should remain a diagnostic possibility in
children. These patients are best assessed using a CT scan. New
research on stem cells and tissue-engineered bioprosthetics may pave
the path for better future therapies in these cases.
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