Simultaneous surgery for complicated giant post-traumatic phrenic hernia in a patient with morbid obesity and diabetes mellitus type II

Objective. To assess the reparative and functional state of the tissues of the postoperative wound during hernioplasty with the endoprosthesis "titanium silk" in patients with diabetes mellitus. Materials and methods. Clinical and laboratory examination was carried out in 37 patients with inguinal hernias using the titanium silk endoprosthesis. The patients were divided into two groups. In the comparison group (n = 20), surgical treatment was performed in patients without diabetes mellitus, in the main group (n = 17), patients had type 1 or 2 diabetes mellitus. In the early postoperative period, the dynamics of healing process in the postoperative period was assessed using cytological and instrumental methods. Results. It was found that inflammation and microcirculation disorders are observed in the tissues of the postoperative period. However, it was noted that when using the endoprosthesis "titanium silk" in patients of both the main and the control groups, no disruption of the reparative processes was detected. Conclusions. The use of titanium mesh endoprostheses "titanium silk" for hernioplasty of inguinal hernias in patients with diabetes mellitus does not violate the fundamental processes of tissue healing in the region of the operation.

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Features of diagnosis and treatment of false post-traumatic diaphragmatic hernias

Bogomolov¹,

Kashafeeva²

2023

Surgeon

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Damage to the diaphragm domes followed by the formation of false diaphragmatic hernias (FDH) occurs with closed and open trauma to the chest and/or abdomen. In this case, the mobile organs of the abdominal cavity, being uncovered by the parietal peritoneum, move to the pleural cavity and, with a small defect in the diaphragm, can be infringed up to necrosis of the organ wall. The rare occurrence of such pathology, the paucity of clinical symptoms, explains the high error rate in diagnosis, especially in primary health care. We have experience in two clinics over 34 years in the treatment of 12 patients with FDH. The left dome was damaged in 10 patients, the right dome in two. The age of damage to the diaphragm ranged from several hours to 7 years. Five clinical examples are presented, combined with the late diagnosis of the disease, the difficulties of diagnosis, even in a clinic using modern imaging tools. All patients are operated on both as planned and as an emergency. Endovideosurgical technologies for diagnosis and treatment are used only in 2 patients. 2 (16.67 %) patients died with a false diaphragmatic hernia due to a severe closed injury against the background of traumatic and hemorrhagic shocks. Conclusions. A clear explanation of the origin of scars on the skin of the chest and abdomen, clarification of the mechanisms and severity of closed injuries in the https://panor.ru/articles/osobennosti-diagnostiki-i-lecheniya-lozhnykh-posttravmaticheskikh-diafragmalnykh-gryzh/92437.html

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Simultaneous surgery for complicated giant post-traumatic phrenic hernia in a patient with morbid obesity and diabetes mellitus type II

Cited by 3 publications

References 8 publications

Strangulated postoperative diaphragmatic hernia

Strangulated postoperative diaphragmatic hernia

Reparative and functional state of postoperative wound tissues during hernioplasty with endoprosthesis "titanium silk" in patients with diabetes mellitus

Features of diagnosis and treatment of false post-traumatic diaphragmatic hernias

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