The Profile of Diaphragmatic Hernias in three tertiary hospitals in South-East Nigeria: A 13-Year Review

Abstract

Background: The diaphragm is a fibro-muscular partition that separates the relatively low-pressure thoracic cavity from the relatively high-pressure abdominal cavity. This difference in pressure causes transmigration of abdominal contents into the thoracic cavity whenever there is a defect, often resulting in cardio-respiratory disturbances.Objective: To describe the profile of diaphragmatic hernias managed in three tertiary hospitals in, South-East Nigeria and compare same with global outcomes.Methodology: Retrospective study of patients with different types of diaphragmatic hernias managed in three centre over a 13-year period was done. Data on demography, types of hernias, mode of presentation, diagnostic methodology, treatment offered and prognosis including complications were obtained from Record Departments of each hospital.Results: There were a total of 44 patients with male to female ratio of 9:2. The ages ranged from 21 days to 840 months. The profile of the hernias was congenital (n=8, 18.2%), acquired traumatic (n= 30, 68.2%) and acquired non-traumatic (n=6, 13.6%). Among the congenital types-four (50%) were central, three (37.5%) were posterior while one (12.5%) was anterior. In the acquired traumatic types, left side was dominant. In the hiatal hernia (acquired non-traumatic), types 1 has the highest occurrence followed by type IV. Associated injuries in traumatic diaphragmatic hernias were the determinants of morbidity.Conclusion: Thoraco-abdominal hernias as described are not uncommon in our centre. Multidisciplinary approach and functional Intensive care unit (ICU) played significant role in the outcome of congenital diaphragmatic hernias. Keywords: Profile, Diaphragm, Hernias, Enug