Goh K, Sasajima T, Inaba M, Kubo Y, Morimoto N, Nosaka T
First Department of Surgery, Asahikawa Medical College, Japan.
Kyobu Geka. 1996 Jun;49(6):449-51.
Traumatic diaphragmatic hernia requires urgent surgical treatment. A 51-year-old female was injured in a speeding car. She had dyspnea, and resistance on the abdominal wall on physical examination. Intra-thoracic and abdominal visceral injury was suspected. A chest roentogenogram and CT scan revealed an obvious diaphragmatic herniation on the left which necessitated emergency operation. On the right semi-lateral position, left thoracoabdominal spiral incision was made through the 7th intercostal space. Good exposure of the chest and abdomen was easily obtained. Herniated organs and the abdominal cavity were thoroughly examined with ease. The diaphragm was repaired directly. She had an uneventful postoperative recovery, and was discharged in 17 days. Thoracoabdominal spiral incision offered an excellent operative exposure for the patient with a possible combined thoracic and abdominal visceral injury.
创伤性膈疝需要紧急手术治疗。一名51岁女性在一辆超速行驶的汽车中受伤。她有呼吸困难，体格检查时腹壁有抵抗感。怀疑有胸内和腹内脏器损伤。胸部X线片和CT扫描显示左侧有明显的膈疝，需要进行急诊手术。采取右侧半侧卧位，经第7肋间做左胸腹螺旋切口。很容易获得良好的胸腹部暴露。轻松地彻底检查了疝出的器官和腹腔。直接修复膈肌。她术后恢复顺利，17天后出院。胸腹螺旋切口为可能合并胸内和腹内脏器损伤的患者提供了极佳的手术暴露。
