Department of Pediatric Surgery, Lady Hardinge Medical College and Kalawati Saran, Children's Hospital, New Delhi, India.
Indian J Pediatr. 2009 Nov;76(11):1167-8. doi: 10.1007/s12098-009-0282-z. Epub 2010 Jan 14.
A 3-yr-old boy presented with respiratory distress of 2 days duration. There was a history of blunt trauma to the lower chest having occurred 5 days earlier. Although missed initially, serial chest X-rays and a computed tomographic (CT) scan revealed an isolated traumatic right-sided diaphragmatic hernia without any injury to the viscera or the ribcage. Laparotomy with reduction of the herniated right lobe of the liver and the transverse colon was performed. Recovery was uneventful. The presentation, diagnosis and management of this relatively uncommon injury is discussed. The need for a high index of suspicion and critical evaluation of appropriate investigations to prevent diagnostic delay and optimize management in patients with traumatic diaphragmatic injury is emphasized.
一位 3 岁男孩因呼吸急促就诊，病程为 2 天。他在 5 天前有过下胸部钝性外伤史。尽管最初被漏诊，但连续的胸部 X 光片和计算机断层扫描（CT）显示出孤立性外伤性右侧横膈疝，没有任何内脏或肋骨损伤。行剖腹手术以复位疝入的肝右叶和横结肠。术后恢复顺利。讨论了这种相对罕见损伤的表现、诊断和治疗。强调了对创伤性横膈损伤患者保持高度怀疑和对适当检查进行批判性评估的必要性，以防止诊断延误并优化管理。
