Wyffels P L, Kenny J N
Am J Surg. 1984 Mar;147(3):414-7. doi: 10.1016/0002-9610(84)90180-6.
A second case of bilateral hemidiaphragmatic rupture with involvement of the esophageal hiatus has been presented. Successful primary repair was accomplished by a transabdominal approach. Blunt diaphragmatic rupture, along with its presentation, diagnosis, and management, are discussed. The first priorities are life-threatening injuries and hemorrhage. Tears of the diaphragm should be considered in all patients with blunt abdominal and thoracic trauma, and when laparotomy or thoracotomy is performed, tears should be searched for visually. With discovery of injury to one hemidiaphragm, injury to the opposite side should be excluded. When identified, bilateral tears should be repaired primarily.
本文报告了第二例双侧膈破裂伴食管裂孔受累的病例。通过经腹入路成功完成了一期修复。文中讨论了钝性膈破裂及其表现、诊断和处理。首要处理的是危及生命的损伤和出血。所有钝性腹部和胸部创伤患者均应考虑膈肌撕裂，在进行剖腹手术或开胸手术时，应肉眼检查有无撕裂。发现一侧膈肌损伤时，应排除对侧损伤。一旦确诊，双侧撕裂应一期修复。
