Travmatik diafragmatik rüptürün yetersiz onarımı sonucu hamilelikte gelişen strangüle diafragmatik herni "Olgu sunumu"

Abstract

A 28 year old woman had rupture of the spleen and diaphragm in a traffic 18 months ago. In the Laparotomy, splenectomy was done and a chest tube was placed in the left pleural space by the abdominal way through the opening in the diaphragm and anterior abdominal wall. The defect in the diaphragm was then repaired primarily over the chest tube. The patient developed a strangulated diaphragmatic hernia 18 months after the traffic accident in place of the chest tube opening in the diaphragm that could not be repaired adequately in the primary treatment. Since the patient was pregnant, increased intraabdominal pressure was suggested to be the predisposing factor in the course of the herniation. This evidence has shown that even very small ruptures in the diaphragm could not heal spotaneously and may cause diaphragmatic herniation particularly in the presence of predisposing factors such as pregnancy. As a result, ruptures in the diaphragm should be repaired completely with primary sutures regardless of the size of the opening.