Feigenberg Z, Salomon J, Levy M J
J Thorac Cardiovasc Surg. 1977 Aug;74(2):249-52.
Thirteen cases of diaphragmatic rupture following blunt trauma or gunshot wounds are presented. In 10 cases the diagnosis of diaphragmatic rupture was made immediately following the injury, and the defect was closed by primary diaphragmatic suture. In three cases, the diagnosis was delayed for 3 to 16 years after the initial trauma. In all of them, abdominal organs such as the colon or liver had migrated into the thoracic cavity. One of them had acute intestinal obstruction and died following several unsuccessful operations. The remaining two patients required plastic repair of the diaphragmatic hernia by a Dacron patch, and both recovered. The clinical and pathological aspects of diaphragmatic rupture, the importance of early diagnosis and surgical correction, and the surgical approach to this entity are considered. The use of Dacron fabric in delayed closure of diaphragmatic defects is described.
本文报告了13例钝性创伤或枪伤后膈肌破裂的病例。其中10例在受伤后立即诊断为膈肌破裂，并通过膈肌一期缝合修复缺损。3例诊断延迟，在初次创伤后3至16年才确诊。所有这些病例中，结肠或肝脏等腹腔脏器已移入胸腔。其中1例发生急性肠梗阻，经多次手术失败后死亡。其余2例患者需要用涤纶补片对膈疝进行整形修复，均康复。文中讨论了膈肌破裂的临床和病理特征、早期诊断和手术矫正的重要性以及针对该病症的手术方法。还描述了涤纶织物在延迟闭合膈肌缺损中的应用。
