胸腔镜辅助下处理创伤性亚急性经膈肌肋间疝。第二例报道。
Thoracolaparoscopic management of a traumatic subacute transdiaphragmatic intercostal hernia. Second case reported.
作者信息
Smith-Singares Eduardo
机构信息
Washington University School of Medicine in St Louis, Memorial Hospital of Carbondale - The Barnes Jewish Collaborative, United States of America.
出版信息
Trauma Case Rep. 2020 May 29;28:100314. doi: 10.1016/j.tcr.2020.100314. eCollection 2020 Aug.
BACKGROUND
Transdiaphragmatic intercostal hernias are extremely rare. Their physiopathology is different from traumatic diaphragmatic ruptures, and their clinical presentation and management strategies place them in a different category than abdominal intercostal hernias.
CASE PRESENTATION
A 56 yo female presented to the outpatient trauma clinic with a symptomatic, subacute left sided transdiaphragmatic intercostal hernia secondary to a motor vehicle crash almost 3 months prior to presentation. The injury was managed with a combined thoracoscopic and laparoscopic approach, only the second time ever this has been reported. She was discharged on POD#3, and after 6 months of follow up continues to do well, without clinical evidence of hernia recurrence.
CONCLUSION
Minimally invasive management of this rare pathology is possible and should be encouraged.
背景
经膈肋间疝极为罕见。其病理生理与创伤性膈肌破裂不同，其临床表现和治疗策略使其与腹侧肋间疝属于不同类别。
病例报告
一名56岁女性因有症状的亚急性左侧经膈肋间疝就诊于门诊创伤诊所，该疝继发于近3个月前的机动车碰撞事故。采用胸腔镜和腹腔镜联合方法进行治疗，这是该方法第二次被报道。患者于术后第3天出院，经过6个月的随访，恢复良好，无疝复发的临床证据。
结论
这种罕见疾病的微创治疗是可行的，应予以鼓励。
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