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Diaphragmatic hernia due to a missed defect Objectives: to review our experience in recognizing and treating surgically the diaphragmatic hernia due to a missed defect. Design: Case series study Setting: Madina Hospital was a police Hospital in south Mogadishu Somalia now Community based Hospital with the support of the ICRC. Subject and Methods: In our studies we considered post-traumatic diaphragmatic hernia. 1423 laparatomies have been performed in our hospital in between 2002-2005. 16 patients developed diaphragmatic hernia due to a missed defect during the operation 4 had symptoms in the immediated post operative period and 12 comeback to Hospital after 2 months- 15 months mean time 8 months. History has been carefully taken- chest X-ray, Barium swallow and Barium meal has been taken with diagnosis of DH.All pts had surgery. Result: DH was diagnosed with clear clinical presentation. All had surgery Post-operative course was uneventful. Conclusion: Small diaphragmatic defects are difficult to diagnose and easy to miss during laparatomy-therefore surgeon should thoroughly explore. |
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