Reid Jennifer E, Gupta Shailvi, Scalea Thomas M, Stein Deborah M
University of Maryland / R Adams Cowley Shock Trauma Center Baltimore, MD, USA.
Trauma Case Rep. 2019 Nov 29;24:100250. doi: 10.1016/j.tcr.2019.100250. eCollection 2019 Dec.
Pericardio-diaphragmatic hernias (PDHs) are exceedingly rare. When found in adults, they are most commonly caused by blunt trauma and require immediate repair. We report a case of a 61-year-old female who presented with shortness of breath, chest pain and fatigue one month after a motor vehicle collision. Imaging revealed an anterior diaphragmatic rupture with herniation of transverse colon and omentum into the left hemithorax with mass effect on the anterior heart. She underwent exploratory laparotomy revealing a pericardio-diaphragmatic hernia with contents further herniating through a lateral pericardial defect into the left chest. The pericardio-diaphragmatic defect was repaired primarily with non-absorbable sutures. There is an average of only one case report of PDH annually and to our knowledge, this is the first report of pericardio-diaphragmatic hernia with concomitant lateral pericardial defect with herniation of contents into the chest.
心包膈疝（PDHs）极为罕见。在成人中发现时，它们最常见的原因是钝性创伤，需要立即修复。我们报告一例61岁女性，在机动车碰撞后1个月出现呼吸急促、胸痛和疲劳。影像学检查显示前膈破裂，横结肠和大网膜疝入左胸腔，对心脏前部产生占位效应。她接受了剖腹探查术，发现心包膈疝，内容物通过心包外侧缺损进一步疝入左胸。心包膈缺损主要用不可吸收缝线修复。每年平均仅有一例心包膈疝的病例报告，据我们所知，这是首例伴有心包外侧缺损且内容物疝入胸腔的心包膈疝报告。
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