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Khirurgii

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Year 2017 Vol. 25 No 3

CASE REPORTS

V. I. TEMIRBULATOV1, 2, M. E. KLETKIN2

POSTTRAUMATIC LEFT-SIDED DIAPHRAGMATIC HERNIA COMPLICATED BY STRANGULATION

FSEE HE "Kursk State Medical University" MH RF 1
BME "Kursk regional clinical hospital" 2
Kursk
The Russian Federation

Post-traumatic strangulated diaphragmatic hernia is characterized by the complexity of diagnosis and a significant number of diagnostic errors, which are fraught with the occurrence of severe complications, up to a lethal outcome. Significant difficulties in diagnosing occur in patients with previously undiagnosed lesions of the diaphragm with thoracoabdominal injuries. Even small-sized diaphragm wounds can lead at various intervals after injury to the dislocation of abdominal organs into the pleural cavity through defects in the diaphragm.Even small-sized diaphragm injury can lead and to the dislocation of abdominal organs into the thoracic cavity through a defect in the diaphragm at various intervals after the injury. The paper presents a clinical case of the posttraumatic strangulated left-sided diaphragmatic hernia complicated by gangrene of the jejunum and transverse colon in a 24 year-old patient. The incarceration occurred 16 months after the undiagnosed left-sided stabbing – cutting thoracoabdominal injury and it was diagnosed only on the third day due to the indistinct clinical symptoms, and the surgery due to organizational issues was carried out in four days after the incarceration in another hospital (regional clinical hospital with a specialized department of thoracic surgery). Despite the severity of complications caused by the strangulated hernia and a long time period priota surgery as well as the traumatic character of the operation, performed consistently via thoracotomy and laparotomy bypass, the patient has recovered.

Keywords: posttraumatic diaphragmatic hernia, diaphragm injury, incarceration, bowel obstruction, gangrene, thoracotomy, laparotomy
p. 312-316 of the original issue
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Address for correspondence:
305007, the Russian Federation, Kursk, Sumskaya str., 45a,
BMU "Kursk Regional Clinical Hospital"
department of thoracic surgery
Tel.: 7 903 875-30-58,
E-mail: kletkin-max@mail.ru,
Maksim E. Kletkin
Information about the authors:
Temirbulatov V.I. MD, Professor of department of surgical diseases, FSEE HE "Kursk State Medical University" MH RF, Head of department of thoracic surgery, BME "Kursk regional clinical hospital".
Kletkin M.E. Physician of department of thoracic surgery, BME "Kursk regional clinical hospital".
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