Dudley A G, Teaford H, Gatewood T S
Obstet Gynecol. 1979 Mar;53(3 Suppl):25S-27S.
Traumatic rupture of the diaphragm may result from trauma or from direct penetrating injuries. The rupture is often an occult injury, which can have a symptom-free interval that may last for years. This paper presents the first 2 reported cases of delayed rupture associated with intrauterine pregnancy. A review of clinical signs and symptoms is presented along with typical radiological findings. Mortality in the nonpregnant state approaches 50% and varies directly with the number of organs involved, the presence of strangulation, and the interval of time from rupture to surgical intervention. The authors conclude that all obstetrical patients with a history of penetrating wounds of the chest or upper abdomen require special evaluation and prompt surgical intervention if delayed rupture of the diaphragm is established.
膈肌创伤性破裂可能由外伤或直接穿透伤引起。这种破裂通常是隐匿性损伤，可能有长达数年的无症状期。本文介绍了首例报告的2例与宫内妊娠相关的延迟性破裂病例。文中呈现了临床体征和症状的综述以及典型的放射学表现。非妊娠状态下的死亡率接近50%，且与受累器官数量、绞窄情况以及从破裂到手术干预的时间间隔直接相关。作者得出结论，所有有胸部或上腹部穿透伤病史的产科患者，若确诊为膈肌延迟性破裂，均需进行特殊评估并及时进行手术干预。
