Solovyov A E
Pavlov Ryazan State Medical University, Ryazan, Russia.
Khirurgiia (Mosk). 2024(4):64-68. doi: 10.17116/hirurgia202404164.
To analyze treatment outcomes in children with traumatic injuries of the diaphragm.
We followed-up 14 children aged 3-18 years with traumatic injuries of the diaphragm. Diagnostic measures included anamnesis, physical examination, pleural and abdominal puncture, bladder catheterization, ultrasound and X-ray examination including CT.
Traumatic brain injury and thoracoabdominal trauma prevailed in children with traumatic injuries of the diaphragm. In 8 children, diaphragm injury was the result of a traffic accident. Of these, 5 ones died at the scene due to traumatic brain injury. In 3 children, diaphragm injury was associated with penetration of an iron pin through the perineum, pelvic cavity, abdominal and chest cavities when falling from a height (=1) and sledding (=2). Two children were littered with a pile of bricks and building materials. One girl suffered a diaphragm injury as a result of a stab wound.
Combined damage to the diaphragm, TBI, chest and abdominal organs are serious injuries. Signs of shock, internal bleeding, respiratory failure and bone fractures come to the fore. Assistance to these children should be carried out in specialized hospitals.
分析儿童膈肌创伤的治疗结果。
我们对14名3至18岁的膈肌创伤儿童进行了随访。诊断措施包括问诊、体格检查、胸腔和腹腔穿刺、膀胱插管、超声以及包括CT在内的X线检查。
膈肌创伤儿童中创伤性脑损伤和胸腹创伤较为常见。8名儿童的膈肌损伤是交通事故所致。其中,5人因创伤性脑损伤在现场死亡。3名儿童的膈肌损伤与从高处坠落(1例)和雪橇事故(2例)时铁针穿透会阴、盆腔、腹腔和胸腔有关。2名儿童被一堆砖块和建筑材料砸中。一名女孩因刺伤导致膈肌损伤。
膈肌、创伤性脑损伤、胸部和腹部器官的合并损伤是严重损伤。休克、内出血、呼吸衰竭和骨折的症状较为突出。应在专科医院对这些儿童进行救治。