J.Jpn. Surg. Soc.. 90(1): 108-113, 1989

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Original article

THE CLINICAL FEATURES OF TRAUMATIC DIAPHRAGMATIC INJURIES WITH OR WITHOUT HERNIATED VISCERAL ORGANS

The difficulty of diagnosis and selectin of operative approach in traumatic diaphragmatic injuries (T.D.l.) have been debated for a long time. The reason why these problems remain unsolved is possibly dueto the inaccuracy in the definition of T.D.I.
We propose to classify the T.D.i. into two categories; diaphragmatic rupture without herniated visceral organs (D.R.) and diaphragmatic hernia with herniated visceral organs (D.H.) . Clinical featuresin these two groups (D.R. in 9 cases and D.H. in 11 cases) were compared and discussed as follows: 1) Intrathoracic injuries were associated in all cases of both groups, but intraabdominal injury was found in 90.9％ of D.H., whereas 33.3％ of D.R. 2) Diagnostic findings in chest X-ray were not observed in D.R., but frequently observed in D.H. 3) All cases of D.R. were operated through a single approach (transabdominal or transthoracic) , but additinal approach was necessary in 78％ of D.H. It is considered that T.D.I. should be classify into D.R. and D.H. because T.D.I. with or without herniated visceral organs exhibit definitely different clinical features.

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