Steinau G, Bosman D, Dreuw B, Schumpelick V
Chirurgische Universitätsklinik, RWTH Aachen.
Chirurg. 1997 May;68(5):509-12. doi: 10.1007/s001040050221.
Diagnosis of diaphragmatic rupture is often missed after blunt thoracic and abdominal injuries. Rupture of the diaphragm is caused either by direct or indirect violence. The clinical manifestations are unpredictable and of infinite variety, and, especially in massively traumatized patients, masked by other injuries. Between 1987 and 1995, 17 patients were treated for traumatic injury of the diaphragm. Four of 17 patients sustained isolated diaphragmatic rupture; in 13 the rupture was combined with other injuries. Preoperatively the following diagnostic procedures were performed: ultrasonography in 12 patients, chest X-ray in 6, computed tomography of the abdomen in 2, water soluble enema into the stomach in 1, and computed tomography of the thorax in 1 patient. Therapy of diaphragmatic injury was performed in 15 patients within 2 days, in one within 1 year and in one 23 years after the accident. Two patients died due to accompanying injuries.
钝性胸腹部损伤后，膈肌破裂的诊断常常被漏诊。膈肌破裂可由直接暴力或间接暴力所致。其临床表现难以预测且多种多样，尤其在严重创伤患者中，常被其他损伤所掩盖。1987年至1995年间，17例患者接受了膈肌创伤治疗。17例患者中4例为单纯膈肌破裂；13例破裂合并其他损伤。术前进行了以下诊断检查：12例行超声检查，6例行胸部X线检查，2例行腹部计算机断层扫描，1例行水溶性钡剂胃造影，1例行胸部计算机断层扫描。15例患者在事故后2天内接受了膈肌损伤治疗，1例在1年后接受治疗，1例在事故后23年接受治疗。2例患者因并发损伤死亡。
