de la Rocha A G, Creel R J, Mulligan G W, Burns C M
Surg Gynecol Obstet. 1982 Feb;154(2):175-80.
Twenty-two instances of diaphragmatic rupture secondary to blunt thoracoabdominal trauma were seen at the Trauma Unit of the Health Sciences Centre, Winnipeg, Manitoba, Canada during a 30 year period. Diaphragmatic laceration occurred in the right leaf in 11, in the left in ten, and in both sides in one instance. In 14, the diagnosis was made and repair effected within 24 hours of presentation. Seven were diagnosed and treated from three days to several years after the injury. Two patients died soon after admission. They were victims of multiple intra-abdominal as well as intrathoracic injuries. Repair was generally effected through a laparotomy during the immediate post-traumatic period. Thoracotomy was used in those diagnosed after the latent interval. The diagnosis of diaphragmatic disruption should be considered in any patient suffering from blunt thoracoabdominal trauma. Usually a roentgenogram of the chest will confirm the suspected injury. In contradistinction to most of the reported series, our experience indicates that right diaphragmatic injuries are more common than what is usually thought.
在加拿大曼尼托巴省温尼伯市健康科学中心创伤科，30年间共收治了22例钝性胸腹联合伤继发膈肌破裂的病例。膈肌裂伤发生于右侧11例，左侧10例，双侧1例。14例在就诊后24小时内确诊并完成修复。7例在受伤后3天至数年才得以诊断和治疗。2例患者入院后不久死亡，均为腹内及胸内多发伤患者。创伤后早期一般通过剖腹手术进行修复。对伤后一段时间才确诊的患者则采用开胸手术。任何钝性胸腹联合伤患者均应考虑膈肌破裂的诊断。通常胸部X线检查可证实疑似损伤。与大多数报道的病例系列不同，我们的经验表明，右侧膈肌损伤比通常认为的更为常见。
