Forni E, Colombo P, Volpato G, Molinari M
Chir Ital. 1979 Oct;31(5):946-62.
Four cases of right traumatic diaphragmatic hernia are reported. The original aspect of this type of lesion is that herniation of abdominal viscera into the chest is usually delayed due to the liver temporary plugging of the diaphragmatic defect. Diagnostic importance of diaphragm elevation combined with mediastinal push-back is stressed, as well as the value of x-ray examination following pneumoperitoneum. Reduction of the hernia and repair of the diaphragmatic defect can easily be accomplished by abdominal route alone, instead by a transthoracic approach usually preferred by surgeons in delayed presentation, particularly in those patients with marked limitation of pulmonary reserve.
报告了4例右外伤性膈疝。这类损伤的初始表现是，由于肝脏暂时堵塞膈肌缺损，腹腔脏器疝入胸腔通常会延迟出现。强调了膈肌抬高合并纵隔后移的诊断重要性，以及气腹后X线检查的价值。通过单纯经腹途径即可轻松完成疝的还纳和膈肌缺损的修复，而不是采用外科医生在延迟就诊时通常首选的经胸入路，尤其是那些肺储备明显受限的患者。
