Pojarliev T, Tzvetkov I, Blagov J, Radionov M
Department of Surgery, MBAL University Hospital, St. Ann, Sofia, Bulgaria.
Surg Endosc. 2003 Apr;17(4):660. doi: 10.1007/s00464-002-4216-3. Epub 2003 Feb 10.
We present the case of a 23-year-old patient who had a car accident with a steering wheel trauma 6 months previously. The patient complained of abdominal pain, getting easily tired, and breathing difficulties. A diagnosis of traumatic diaphragmatic hernia was established by a contrast radiographic examination. Laparoscopy confirmed a rupture of the left diaphragmatic cupola and prolapse of the stomach, small intestine, and colon in the left thoracic cavity. Laparoscopic repair of the diaphragm with polypropylene mesh was performed. The patient recovered rapidly and was discharged 72 h after the operation. The control radiographs and computed tomography (CT) contrast investigations showed no recurrence. The patient's preoperative complaints had resolved completely. The case is interesting because traumatic diaphragmatic hernia is sometimes difficult to diagnose. Its laparoscopic treatment is still a challenge for modern surgery, and there are not enough publications on the problem.
我们报告一例23岁患者,其在6个月前遭遇车祸,方向盘造成胸部创伤。患者主诉腹痛、易疲劳及呼吸困难。通过造影X线检查确诊为创伤性膈疝。腹腔镜检查证实左膈穹窿破裂,胃、小肠和结肠脱垂至左胸腔。采用聚丙烯网片进行腹腔镜膈修补术。患者恢复迅速,术后72小时出院。对照X线片和计算机断层扫描(CT)造影检查未显示复发。患者术前的主诉已完全消失。该病例很有意思,因为创伤性膈疝有时难以诊断。其腹腔镜治疗对现代外科手术来说仍是一项挑战,而且关于这个问题的相关文献并不充足。