Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Am J Emerg Med. 2012 Nov;30(9):2089.e1-3. doi: 10.1016/j.ajem.2011.12.027. Epub 2012 Feb 4.
Right diaphragmatic hernia is a rare injury (0.25%-1%) after blunt abdominal trauma. The diagnosis may be delayed and achieved years after the trauma. We currently report a case of a 48-year-old man who presented to the emergency department at Far Eastern Memorial Hospital, New Taipei City, Taiwan, demonstrating signs of herniation of the right diaphragm. The herniation was confirmed using a chest radiograph. The patient reported falling 3 years before the current evaluation and was symptom-free before arrival in the emergency department. The diagnosis was further confirmed through thoracoabdominal computed tomography. The diaphragmatic hernia was subsequently repaired via abdominal approach. For patients with a history of prior thoracoabdominal trauma with complaints of new abdominal pain, a delayed diaphragmatic hernia should be considered.
右侧横膈疝是钝性腹部创伤后罕见的损伤(0.25%-1%)。诊断可能会延迟,并且可能在创伤后数年才得以确诊。我们目前报告了 1 例 48 岁男性患者,他因出现右侧横膈疝的突出表现而到台湾新北市的振兴医院急诊科就诊。通过胸部 X 光片确认了疝出。患者报告在当前评估前 3 年前跌倒,在到达急诊科之前无症状。通过胸腹部计算机断层扫描进一步确诊。膈疝随后通过腹部入路进行修复。对于有既往胸腹部创伤史且有新出现腹痛症状的患者,应考虑延迟性膈疝。