Parra Michael W, Rodas Edgar B, Bartnik Jakub P, Puente Ivan
Department of Surgery, Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL, USA.
J Emerg Trauma Shock. 2011 Jul;4(3):425-6. doi: 10.4103/0974-2700.83879.
We describe the first reported survivor of a delayed trans-diaphragmatic hepatic rupture complicated by acute superior vena cava (SVCS) and thoracic compartment syndromes (TCS). A thirty one year old male was involved in a boating accident. The patient was diagnosed with a grade IV liver laceration, which was initially managed with both angio-embolization and open surgical repair. Exactly one month from admission, the patient presented with an abrupt cardiac arrest, which was further complicated by a SVCS and TCS. The SVCS was managed with bilateral thoracostomies which revealed a delayed trans-diaphragmatic hepatic rupture into the right chest cavity. The TCS was managed with a decompressive thoraco-abdominal incision. The patient survived and is now leading a normal life. Our success was largely due to an integrated trauma system of physicians, nurses and technicians that prompted the early recognition of two potentially life threatening complications of a delayed trans-diaphragmatic hepatic rupture.
我们报道了首例延迟性经膈肝破裂合并急性上腔静脉综合征（SVCS）和胸廓间隔综合征（TCS）的幸存者。一名31岁男性遭遇划船事故。患者被诊断为IV级肝裂伤，最初采用血管栓塞和开放手术修复进行治疗。入院整整一个月后，患者突然心脏骤停，并进一步并发SVCS和TCS。通过双侧胸腔造口术处理SVCS，结果发现存在延迟性经膈肝破裂并破入右胸腔。通过胸腹减压切口处理TCS。患者存活下来，现在过着正常生活。我们的成功很大程度上归功于由医生、护士和技术人员组成的综合创伤系统，该系统促使早期识别出延迟性经膈肝破裂的两种潜在危及生命的并发症。
