Sano Akihiko, Kato Hiroyuki, Hamatani Hiroko, Sakai Makoto, Tanaka Naritaka, Inose Takanori, Kimura Hitoshi, Kuwano Hiroyuki
Department of General Surgical Science (Surgery I), Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Surg Today. 2008;38(9):836-40. doi: 10.1007/s00595-007-3718-y. Epub 2008 Aug 28.
Diaphragmatic hernia complicating pregnancy is rare and is associated with high morbidity and mortality, particularly if surgical intervention is delayed. We report a case of diaphragmatic hernia in a pregnant 25-year-old woman. The patient was referred to our hospital in respiratory distress in the 28th week of her pregnancy. Chest radiograph and computed tomography showed air-filled bowel loops in the left side of the chest, with a marked mediastinal shift. Immediately after an emergency caesarean section, the herniated abdominal viscera were reduced through the opening in the diaphragm. We resected the ischemic segment of ileum and repaired the diaphragmatic defect with interrupted sutures and a Gore-Tex sheet. She had an uneventful postoperative course and her baby boy also recovered well. We report this case to alert surgeons to the possibility of this rare surgical emergency during pregnancy.
妊娠合并膈疝较为罕见,且与高发病率和死亡率相关,尤其是手术干预延迟时。我们报告一例25岁妊娠女性发生膈疝的病例。该患者在妊娠第28周因呼吸窘迫被转诊至我院。胸部X线片和计算机断层扫描显示胸腔左侧有充满气体的肠袢,伴有明显的纵隔移位。紧急剖宫产术后,立即通过膈肌开口将疝入的腹腔脏器回纳。我们切除了缺血的回肠段,并用间断缝合和一块戈尔特斯补片修复了膈肌缺损。她术后恢复顺利,她的男婴也恢复良好。我们报告此病例以提醒外科医生注意妊娠期间这种罕见外科急症的可能性。