Shea L, Graham A D, Fletcher J C, Watkins G M
J Trauma. 1982 Jul;22(7):539-43.
Traumatic diaphragmatic hernia, whether of blunt or penetrating etiology, is difficult to diagnose in the acute phase. The lesion is presently best diagnosed by chest X-ray, but only occasionally. Chest X-ray appears normal or nonspecific 25 to 50% of the time. For this reason, simple diagnostic technique using radiographic methodology available in emergency rooms was studied in animals in order to devise a way to diagnose this injury. Eight per cent diatrizoate meglumine and diatrizoate sodium (Renografin, Squibb) was placed into the chest or abdomen of animals with either 8-cm simulated blunt or 5-mm simulated penetrating injuries. The Renografin was infused by either a peritoneal lavage or thoracostomy catheter. Serial X-rays showed diagnostic rate of transdiaphragmatic leakage in 24 of 26 animals with blunt injury and seven of 16 animals with penetrating injury. There was no evidence of pleural, peritoneal, or pulmonary injury from the Renografin itself. It was concluded that the experimental technique may prove useful in screening or confirming traumatic diaphragmatic hernia during the acute or latent phases.
创伤性膈疝，无论病因是钝性还是穿透性，在急性期都难以诊断。目前，该病变最好通过胸部X线检查来诊断，但这种情况仅偶尔出现。胸部X线检查在25%至50%的情况下表现正常或不具有特异性。因此，为了找到一种诊断这种损伤的方法，研究人员在动物身上使用急诊室可用的放射学方法进行了简单的诊断技术研究。将8%的泛影葡胺和泛影酸钠（复方泛影葡胺，施贵宝公司生产）注入患有8厘米模拟钝性损伤或5毫米模拟穿透性损伤的动物的胸部或腹部。通过腹膜灌洗或胸腔造口导管注入复方泛影葡胺。连续的X线检查显示，在26只钝性损伤动物中有24只、16只穿透性损伤动物中有7只出现了膈下渗漏的诊断率。没有证据表明复方泛影葡胺本身会造成胸膜、腹膜或肺部损伤。研究得出结论，该实验技术可能在急性或潜伏期筛查或确诊创伤性膈疝方面证明是有用的。
