Department of Surgery I, Charité Medical School, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany.
Surg Today. 2010 Sep;40(9):874-7. doi: 10.1007/s00595-009-4172-9. Epub 2010 Aug 26.
Diaphragmatic hernias are becoming increasingly common due to radiofrequency ablation of malignant liver tumors. Most patients eventually present with symptoms caused by bowel obstruction. A 54-year-old woman with pleuritic pain and fever had a right-sided enterothorax probably caused by hemihepatectomy several years before. The patient was diagnosed with perforated gangrenous intrathoracic appendicitis during an emergency laparotomy for suspected incarceration of her diaphragmatic hernia. She was treated with an appendectomy and suturing of her right hemidiaphragm. An acquired diaphragmatic hernia should therefore be surgically repaired as soon as it is diagnosed in order to avoid complications.
膈疝由于射频消融恶性肝肿瘤而变得越来越常见。大多数患者最终会出现肠梗阻引起的症状。一名 54 岁女性因胸痛和发热就诊，数年前因右半肝切除术可能出现右侧肠胸瘘。该患者在因疑似膈疝嵌顿而行紧急剖腹探查时被诊断为穿孔性坏疽性胸内阑尾炎。她接受了阑尾切除术和右侧膈肌缝合术。因此，一旦诊断出获得性膈疝，应尽快进行手术修复，以避免并发症。
