Slim K
Service de Chirurgie Générale et Digestive, CHU, Clermont-Ferrand.
J Chir (Paris). 1999 Jun;136(2):67-75.
Injury to the diaphragm is a marker of severe trauma yet remains one of the most misdiagnosed traumatic lesions. The mechanism may be penetrating (stab or gunshot wounds) or blunt (high velocity injuries). Rupture of the diaphragm may be overlooked due to common associated injuries. Diagnosis is based on strong clinical suspicion and repeated chest x-rays. Current diagnostic tools include CT scan and minimally invasive surgical techniques (laparoscopy or thoracoscopy) in stable patients. These relatively new methods could provide more accurate diagnosis. The main feature of diaphragmatic injury is the incidence of late presentation with the possibility of life-threatening complications such as strangulations may even occur late.
膈肌损伤是严重创伤的一个标志,但仍是最常被误诊的创伤性损伤之一。其机制可能是穿透性的(刺伤或枪伤)或钝性的(高速损伤)。由于常伴有其他损伤,膈肌破裂可能被忽视。诊断基于强烈的临床怀疑和多次胸部X光检查。目前的诊断工具包括CT扫描以及用于病情稳定患者的微创外科技术(腹腔镜检查或胸腔镜检查)。这些相对较新的方法能提供更准确的诊断。膈肌损伤的主要特点是出现延迟,甚至可能出现危及生命的并发症,如绞窄,且这些并发症可能在后期才发生。