Kuhn R, Schubert D, Marusch F, Lippert H, Pross M
Department of Surgery, Otto-von-Guericke University Magdeburg, Leipziger Strasse 44, Germany.
Surg Endosc. 2002 Oct;16(10):1495. doi: 10.1007/s00464-001-4236-4. Epub 2002 Jul 1.
Diaphragmatic hernias after blunt traumatic damage are serious complications, and diagnosis often might be delayed. In most cases, early symptoms are missed, but in the further posttraumatic period, patients experience recurrence of pulmonary dysfunction or intestinal symptoms such as obstruction, nausea, and pain. Most of these defects are diagnosed by laparotomy performed to investigate other major abdominal lesions. These diaphragmatic ruptures are managed by suturing using a thoracic or abdominal approach. An original diaphragmatic repair technique using a patch is presented. A 40-year-old woman was admitted to our clinic because of chronic abdominal pain. Chest x-ray and computed tomography scan showed a migration of the large intestine into the left hemithorax. A large diaphragmatic hernia was diagnosed and repaired laparoscopically using a patch. In the reported patient, laparoscopic suture of a diaphragmatic hernia using a polytetrafluoroethylene (PTFE) (GORETEX) patch proved to be safe, successful, elegant, and uneventful.
钝性创伤后发生的膈肌疝是严重的并发症,诊断往往会延迟。在大多数情况下,早期症状会被漏诊,但在创伤后期,患者会出现肺功能障碍复发或肠梗阻、恶心、疼痛等肠道症状。这些缺损大多是在为检查其他主要腹部病变而进行剖腹手术时被诊断出来的。这些膈肌破裂通过采用胸部或腹部入路进行缝合来处理。本文介绍了一种使用补片的膈肌修补新技术。一名40岁女性因慢性腹痛入住我院。胸部X线和计算机断层扫描显示大肠移入左半胸。诊断为巨大膈肌疝,并通过腹腔镜使用补片进行修补。在该病例中,使用聚四氟乙烯(PTFE)(戈尔特斯)补片对膈肌疝进行腹腔镜缝合被证明是安全、成功、简便且顺利的。