Degiannis E, Levy R D, Sofianos C, Potokar T, Florizoone M G, Saadia R
Department of Surgery, Baragwanath Hospital, University of the Witwatersrand Medical School, Johannesburg, South Africa.
Br J Surg. 1996 Jan;83(1):88-91. doi: 10.1002/bjs.1800830128.
A study was made of 45 patients with diaphragmatic herniation after penetrating trauma. In 29 the diagnosis was established during the first admission (early presentation) and in 16 during a subsequent admission (delayed presentation). The mortality rate in the early presentation group was 3 per cent compared with 25 per cent in the delayed presentation group. The presence of gangrenous or perforated abdominal viscus in the chest cavity was the single most common and severe aggravating factor. The need for diagnosis of diaphragmatic herniation during the initial admission is emphasized. As isolated diaphragmatic injuries provide few helpful clinical features to aid diagnosis, appropriate investigations and good follow-up are of paramount importance in preventing late herniation of intra-abdominal viscera through a penetrating diaphragmatic injury.
对45例穿透性创伤后膈肌疝患者进行了研究。其中29例在首次入院时确诊（早期表现），16例在随后的入院时确诊（延迟表现）。早期表现组的死亡率为3%，而延迟表现组为25%。胸腔内存在坏疽或穿孔的腹腔脏器是最常见且严重的加重因素。强调了在初次入院时诊断膈肌疝的必要性。由于单纯的膈肌损伤提供的有助于诊断的临床特征很少，适当的检查和良好的随访对于预防腹腔脏器通过穿透性膈肌损伤发生晚期疝至关重要。
