Yoshida J, Iwai T, Koike E, Akao M, Shimura H
Division of General Thoracic Surgery, Shimonoseki City Hospital, Japan.
Kyobu Geka. 1998 Mar;51(3):197-200.
A 46-year-old male taxi driver was stabbed onto the left chest while on duty. On arrival soon after, he was hemodynamically stable. Computed tomography showed omental prolapse into the left thorax through the diaphragm. On the 11th day, he underwent thoracoscopy revealing omental prolapse via a 3-cm rent in the left diaphragm, which was reduced manually. The diaphragmatic orifice was lifted and debrided with suturing using a stapling cutter. The post-operative course was uneventful. Finger palpation through the orifice enabled safe suturing of the left diaphragm facing the omentum, the colon, and the stomach, all of which may suffer iatrogenic injury.
一名46岁的男性出租车司机在执勤时被刺伤左胸。受伤后不久到达医院时,他的血流动力学稳定。计算机断层扫描显示网膜通过膈肌脱垂至左胸腔。在第11天,他接受了胸腔镜检查,发现左膈肌有一个3厘米的裂口导致网膜脱垂,遂手动将其复位。用吻合器提起并清创膈肌孔并缝合。术后过程顺利。通过该孔进行手指触诊有助于安全缝合左膈肌,避免网膜、结肠和胃受到医源性损伤。