Igai Hitoshi, Kamiyoshihara Mitsuhiro, Yoshikawa Ryohei, Ohsawa Fumi, Yazawa Tomohiro
Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, 389-1 Asakura-cho, Maebashi, Gunma, 371-0811, Japan.
Gen Thorac Cardiovasc Surg. 2019 Sep;67(9):811-813. doi: 10.1007/s11748-018-1033-8. Epub 2018 Nov 10.
A delayed hemothorax requiring surgical treatment is considered a rare minor thoracic injury. We experienced four cases of delayed massive hemothorax due to a diaphragmatic laceration caused by lower rib fractures. A computed tomography scan on admission revealed multiple rib fractures in all patients, and at least one fractured lower rib was severely displaced, which injured the diaphragm. The duration between the injury and the diagnosis were 14 h-30 days. Emergency surgical treatment was performed, and intraoperative findings revealed a diaphragmatic laceration with oozing due to injury caused by the edge of a fractured rib. After the operation, all patients were successfully discharged.
需要手术治疗的迟发性血胸被认为是一种罕见的轻度胸部损伤。我们遇到了4例因下肋骨骨折导致膈肌撕裂而引起的迟发性大量血胸。入院时的计算机断层扫描显示所有患者均有多处肋骨骨折,且至少有一根下肋骨骨折严重移位,损伤了膈肌。受伤至诊断的时间为14小时至30天。均进行了急诊手术治疗,术中发现膈肌有撕裂伤,因骨折肋骨边缘损伤而渗血。术后所有患者均成功出院。