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穿过孔洞:肿瘤细胞减灭术后迟发性膈疝

Passing Through a Hole: Delayed Diaphragmatic Hernia After Cytoreductive Surgery.

作者信息

Mestre Ana, Ferreira Simões André, Marino Flávio, Gonçalves Pereira João

机构信息

Internal Medicine, Hospital Distrital de Santarém, Santarém, PRT.

Intensive Care Unit Department, Hospital Vila Franca de Xira, Vila Franca de Xira, PRT.

出版信息

Cureus. 2021 Dec 9;13(12):e20314. doi: 10.7759/cureus.20314. eCollection 2021 Dec.

Abstract

A diaphragmatic hernia is a protrusion of abdominal contents into the thoracic cavity. Although it is commonly congenital, diaphragmatic hernias can also be acquired. Blunt or penetrating trauma are among the most frequent causes, although spontaneous or iatrogenic cases have been reported. Recently, some case reports related to diaphragmatic hernia after debulking surgery for advanced ovarian cancer have been described. This is an exceedingly rare but life-threatening complication, being prompt recognition and surgical correction critical. We report a case of a delayed diaphragmatic hernia in a 19-year-old female resulting from cytoreductive surgery for advanced ovarian cancer. Rapid evolution from gastrointestinal symptoms to hypovolemic shock occurred, and intensive care admission was required. Immediate surgery was critical to improving the patient outcome. This case highlights this uncommon but life-threatening complication, the challenges of diagnosing and managing those patients, and the need for early recognition, support, and surgical correction.

摘要

膈疝是腹腔内容物突入胸腔。虽然膈疝通常是先天性的,但也可能是后天获得性的。钝性或穿透性创伤是最常见的病因,不过也有自发性或医源性病例的报道。最近,已有一些关于晚期卵巢癌肿瘤减灭术后发生膈疝的病例报告。这是一种极其罕见但危及生命的并发症,及时识别和手术矫正至关重要。我们报告一例19岁女性因晚期卵巢癌行肿瘤细胞减灭术导致延迟性膈疝的病例。患者从胃肠道症状迅速发展为低血容量性休克,需要入住重症监护病房。立即手术对于改善患者预后至关重要。本病例凸显了这种罕见但危及生命的并发症、诊断和管理这些患者的挑战,以及早期识别、支持和手术矫正的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ebe/8742876/35c20a9a1a4a/cureus-0013-00000020314-i01.jpg

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