Amadou Magagi Ibrahim, Habou Oumarou, Adamou Harissou, Adakal Ousseini, Ali Ada Mahamoud Omid, Moustapha Hellé, Abarchi Habibou
General Surgery Department, National Hospital of Zinder, Zinder, Niger.
Pediatric Surgery Department, National Hospital of Zinder, Zinder, Niger.
Case Rep Surg. 2018 Feb 19;2018:8758021. doi: 10.1155/2018/8758021. eCollection 2018.
Diaphragm is a compliant musculoaponeurotic barrier located between thoracic and abdominal cavities. Traumatic diaphragmatic rupture is a rare clinicopathological entity. We report a case of right-sided posttraumatic hernia in a child following blunt trauma to highlight diagnostic difficulties and therapeutic specific aspects. A 10-year-old boy was admitted to the emergency surgical department with thoracic trauma following pedestrian accident. At admission a haemothorax was suspected and treated by pleural drainage. The diagnosis of a right-sided diaphragmatic rupture was made after computed tomographic scan forty-eight hours later. At surgery, a reduction of herniated abdominal content and a suture of diaphragmatic defect were performed. The postoperative recoveries were uneventful and the patient was followed up for 12 months without symptoms. The possibility of a diaphragmatic rupture should be kept in mind and sought after any trauma of the thoracoabdominal junction as the diagnosis can be challenging in emergency department.
膈肌是位于胸腔和腹腔之间的顺应性肌肉腱膜屏障。创伤性膈肌破裂是一种罕见的临床病理实体。我们报告一例儿童钝性创伤后右侧创伤性疝，以突出诊断困难和治疗的特殊方面。一名10岁男孩因行人事故导致胸部创伤被收入急诊外科。入院时怀疑有血胸并进行了胸腔引流治疗。48小时后经计算机断层扫描确诊为右侧膈肌破裂。手术中，对疝入的腹腔内容物进行了还纳，并缝合了膈肌缺损。术后恢复顺利，对患者进行了12个月的随访，无任何症状。应牢记膈肌破裂的可能性，在胸腹部交界处发生任何创伤后都应进行排查，因为在急诊科诊断可能具有挑战性。
