Meaigel Mohammad A, Haider Mohammed A, Touloumis Zisis
Trauma Surgery, King Saud University, Riyadh, SAU.
Trauma Surgery, King Saud Medical City, Riyadh, SAU.
Cureus. 2023 Aug 1;15(8):e42828. doi: 10.7759/cureus.42828. eCollection 2023 Aug.
Diaphragmatic injuries, particularly on the right side, are a rare yet challenging clinical scenario, especially when associated with other injuries. We present the case of a 38-year-old male patient who sustained a fall from a significant height, resulting in blunt abdominal trauma, chest injuries, right-side diaphragmatic injury, a grade 4 liver injury, and fractures of the right ribs, right femur, and pelvis. The patient also suffered a lung laceration with hemopneumothorax. The clinical team managed these injuries through a video-assisted thoracoscopy, laparotomy, and primary repair of the diaphragmatic rupture. The postoperative course was complicated by a low-output bile leak and infection of the orthopedic surgical wound, but these were effectively managed, and the patient showed a steady recovery. This case underscores the complexity of managing traumatic injuries that span multiple body regions and systems, requiring a coordinated, multidisciplinary approach. It also highlights the critical role of timely intervention and appropriate surgical strategies in the successful recovery of patients from complex traumas.
膈肌损伤，尤其是右侧膈肌损伤，是一种罕见但具有挑战性的临床情况，特别是当与其他损伤相关联时。我们报告一例38岁男性患者，他从高处坠落，导致钝性腹部创伤、胸部损伤、右侧膈肌损伤、4级肝损伤以及右侧肋骨、右股骨和骨盆骨折。患者还出现了伴有血气胸的肺裂伤。临床团队通过电视辅助胸腔镜手术、剖腹手术和膈肌破裂的一期修复来处理这些损伤。术后过程因低流量胆汁漏和骨科手术伤口感染而复杂化，但这些问题得到了有效处理，患者显示出稳步康复。该病例强调了处理跨越多个身体区域和系统的创伤性损伤的复杂性，需要一种协调的多学科方法。它还突出了及时干预和适当手术策略在患者从复杂创伤中成功康复中的关键作用。
