TRAITEMENT CHIRURGICAL DES RUPTURES TRAUMATIQUES DU DIAPHRAGME : A PROPOS DE 13 CAS A L’HOPITAL DU MALI

Abstract

Introduction: traumatic rupture of the diaphragm corresponds to a traumatic breach of the diaphragm which can be complicated by an intrathoracic herniation of the abdominal viscera. Objective: describe the diagnostic and therapeutic aspects of diaphragmatic ruptures. Patients and Method: We conducted a retrospective and descriptive study from March 2012 to September 2020, carried out in the thoracic surgery department at the Mali Hospital. Patients with traumatic rupture of the diaphragm were included. The diagnostic, therapeutic and evolutionary aspects were analyzed. Results: we collected thirteen (13) cases with an average age of 28.8 years with an extreme of 3 and 59 years. There were 10 men and 3 women. The etiology was road accidents in 6 cases. CT made it possible to make the diagnosis in 10 patients. A thoracotomy was performed in 12 patients. The most frequent herniated organs were the stomach in 11 cases and the colon in 6 cases. The average size of the rupture was 7.3 cm and was located at the level of the muscular body in 8 cases. Associated lesions were found in 9 cases. Treatment consisted of reduction of the herniated organs, suture of the breach and repair of associated lesions. The evolution was favorable in 12 cases. A case of death was recorded. Conclusion: Diaphragmatic rupture is an uncommon lesion which most often reflects serious trauma whose prognosis depends on the associated lesions. The thoracic route is an interesting alternative for the treatment of diaphragmatic lesions