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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.

DOI:10.1016/j.tcr.2020.100314
PMID:32509954
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7264079/
Abstract

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.

摘要

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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本文引用的文献

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Traumatic thoracoabdominal hernia repair using a novel chest-wall reconstruction technique: a case report.采用新型胸壁重建技术修复创伤性胸腹疝:1例病例报告
Ann R Coll Surg Engl. 2020 Jan;102(1):e4-e6. doi: 10.1308/rcsann.2019.0120. Epub 2019 Sep 11.
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Macroeconomic trends and practice models impacting acute care surgery.影响急性护理手术的宏观经济趋势与实践模式。
Trauma Surg Acute Care Open. 2019 Apr 11;4(1):e000295. doi: 10.1136/tsaco-2018-000295. eCollection 2019.
3
Unifying classification for transdiaphragmatic intercostal hernia and other costal margin injuries.
统一胸壁疝和其他肋缘损伤的分类。
Eur J Cardiothorac Surg. 2019 Jul 1;56(1):150-158. doi: 10.1093/ejcts/ezz020.
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Surgical deserts in California: an analysis of access to surgical care.加利福尼亚州的手术荒漠:手术治疗可及性分析
J Surg Res. 2018 Mar;223:102-108. doi: 10.1016/j.jss.2017.10.014. Epub 2017 Nov 15.
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A Case of Spontaneous Transdiaphragmatic Intercostal Hernia with Contralateral Injury, and Review of the Literature.一例伴有对侧损伤的自发性经膈肋间疝病例及文献复习
Case Rep Surg. 2017;2017:7416092. doi: 10.1155/2017/7416092. Epub 2017 Feb 23.
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Diaphragmatic injuries and post-traumatic diaphragmatic hernias.膈肌损伤与创伤后膈疝
Curr Probl Surg. 2017 Jan;54(1):11-32. doi: 10.1067/j.cpsurg.2016.11.001. Epub 2016 Nov 29.
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