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创伤性膈肌破裂伴肝脏疝出的延迟诊断:一例报告

Delayed diagnosis of traumatic diaphragmatic rupture with herniation of the liver: a case report.

作者信息

Kuppusamy Anand, Ramanathan Gayathri, Gurusamy Jayakar, Ramamoorthy Balaji, Parasakthi Karunanithi

机构信息

Department of Anaesthesiology, SRM Medical College Hospital & Research Centre, Kattankulathur, Tamilnadu, India.

出版信息

Ulus Travma Acil Cerrahi Derg. 2012 Mar;18(2):175-7. doi: 10.5505/tjtes.2012.79477.

Abstract

Diaphragmatic rupture is a potentially life-threatening clinical situation. It occurs as a result of high-velocity blunt or penetrating injury to the abdomen and thorax. Acute traumatic rupture of the diaphragm may go undetected, and there is often a delay between the injury and diagnosis. Right-sided rupture is less common due to hepatic protection and increased strength of the right hemidiaphragm. We report the case of a 28-year-old man who was admitted with breathlessness to our hospital, 72 hours after trauma. Since clinical signs and symptoms were nonspecific, helical computed tomography was done, which revealed diaphragmatic rupture with hepatothorax. Emergency thoracotomy was done to repair diaphragmatic rent. The postoperative period was uneventful, and the patient was discharged three weeks later.

摘要

膈肌破裂是一种潜在的危及生命的临床情况。它是由腹部和胸部的高速钝性或穿透性损伤引起的。急性创伤性膈肌破裂可能未被发现,而且损伤与诊断之间往往存在延迟。由于肝脏的保护作用以及右侧半膈肌强度增加,右侧破裂较少见。我们报告一例28岁男性患者,在创伤72小时后因呼吸困难入住我院。由于临床体征和症状不具特异性,故进行了螺旋计算机断层扫描,结果显示膈肌破裂伴肝胸。急诊开胸手术修复膈肌裂孔。术后恢复顺利,患者三周后出院。

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