Muro K, Yanagihara K, Mizuno H, Kurata M
Department of Surgery, Kyoto Hakuaikai Hospital, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 May;46(5):486-90. doi: 10.1007/BF03217777.
A 71-year-old woman, in whom the herniation of right-sided diaphragm was diagnosed, was admitted to our hospital on ambulance car complaining of increasing right-sided chest pain and worsening of dyspnea. She was given emergency laparotomy. The transverse colon and omentum pushed the liver backward. The tight adhesion between transverse colon and diaphragm was released by using thoracotomy additionally. In pleural cavity, there was prolapsing transverse colon which was not covered with peritonium and was caused by the rupture of right-sided diaphragm. The necrotic transverse colon was resected about 30 cm length. We considered that the rupture was caused not by external injury but by inflammation after plication for diaphragm eventration three years and ten months before.
一名71岁女性,被诊断为右侧膈肌疝,因右侧胸痛加重和呼吸困难恶化,由救护车送往我院。她接受了急诊剖腹手术。横结肠和大网膜将肝脏向后推。通过额外开胸手术松解了横结肠与膈肌之间的紧密粘连。在胸腔内,有一段未被腹膜覆盖的横结肠脱垂,是由右侧膈肌破裂所致。切除了约30厘米长的坏死横结肠。我们认为破裂并非由外伤引起,而是三年零十个月前膈肌膨出折叠术后炎症所致。