Stavem K, Larmo A, Gundersen B
Medisinsk avdeling, Sentralsykehuset, Akershus, Nordbyhagen.
Tidsskr Nor Laegeforen. 1993 May 20;113(13):1577-8.
The diagnosis of diaphragmatic rupture is most commonly made during surgical exploration following penetrating injuries, or in the presence of obvious herniation of viscera through the diaphragm. In the absence of acute herniation a diaphragmatic rupture frequently remains unrecognized and may cause herniation of intra-abdominal contents into the thorax after latency periods of up to several decades. Therefore diaphragmatic rupture is an important differential diagnosis in subjects with unclear abdominal conditions or unexplained pleural effusion in the presence of a history of previous thoracoabdominal trauma. A case is presented which highlights pitfalls and clinical findings.
膈肌破裂的诊断最常见于穿透性损伤后的手术探查期间，或存在脏器明显通过膈肌疝出的情况。在没有急性疝出的情况下，膈肌破裂常常未被识别，并且在长达数十年的潜伏期后可能导致腹腔内容物疝入胸腔。因此，对于有既往胸腹外伤史且腹部情况不明或有不明原因胸腔积液的患者，膈肌破裂是一项重要的鉴别诊断。本文介绍了一个突出陷阱和临床发现的病例。
