Dahal S, Koju R, Shrestha B, Karki T, Bade S
Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.
Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.
Int J Surg Case Rep. 2020;77:664-667. doi: 10.1016/j.ijscr.2020.11.018. Epub 2020 Nov 24.
Most of the cases of diaphragmatic rupture occur following abdominal trauma and herniation of abdominal organs into the thorax can occur.
Twenty three years old male presented after a blunt abdominal trauma following a road traffic accident. Investigations revealed a left sided diaphragmatic rupture with herniation of spleen and stomach into the left hemithorax. Surgical repair of the defect was done and splenectomy had to be done due to extensive splenic laceration. Two third of the spleen was found in the left hemithorax.
Diagnosis of diaphragmatic rupture can be missed in cases of polytrauma. High clinical suspicion with aids from imaging modalities help in the diagnosis. In suspicion of herniation of abdominal contents into the thorax, one should be careful in insertion of chest tube in view of damaging the herniated organs. Treatment is surgical repair and reduction of herniated contents.
Although a rare entity, diaphragmatic rupture can occur in cases of abdominal trauma. High clinical suspicion with imaging helps in the diagnosis.
大多数膈肌破裂病例发生在腹部创伤后，可出现腹部器官疝入胸腔的情况。
一名23岁男性在道路交通事故导致钝性腹部创伤后就诊。检查发现左侧膈肌破裂，脾脏和胃疝入左半胸。对缺损进行了手术修复，由于脾脏广泛撕裂不得不进行脾切除术。发现三分之二的脾脏位于左半胸。
多发伤病例中可能漏诊膈肌破裂。高度的临床怀疑加上影像学检查有助于诊断。怀疑有腹部内容物疝入胸腔时，鉴于可能损伤疝入的器官，在插入胸管时应小心。治疗方法是手术修复并还纳疝入的内容物。
尽管膈肌破裂是一种罕见情况，但在腹部创伤病例中可能发生。高度的临床怀疑和影像学检查有助于诊断。
