Wirbel R J, Mutschler W
Department of Trauma Surgery, University of Saarland, Homburg, Germany.
Surg Today. 1998;28(8):850-2. doi: 10.1007/s005950050240.
We present herein a case of blunt rupture of the right hemidiaphragm occurring with complete intrathoracic dislocation of the right hepatic lobe in a polytraumatized patient. The initial chest X-ray was interpreted as right-sided hemothorax, and a thoracic drainage tube was accidentally placed into the liver. A computed tomography scan subsequently revealed diaphragmantic rupture with intrathoracic liver dislocation. It was possible to reposition the liver, and the extended dorsal diaphragmatic rupture was closed primarily through an abdominal approach. The problems associated with the diagnosis and operative treatment of fresh right-sided blunt traumatic diaphragmatic ruptures are discussed following this case report.
我们在此报告一例多发伤患者,其右半膈钝性破裂伴右肝叶完全胸腔内脱位。最初的胸部X线片被解读为右侧血胸,一根胸腔引流管意外置入肝脏。随后的计算机断层扫描显示膈肌破裂伴肝脏胸腔内脱位。肝脏得以复位,扩大的膈肌背侧破裂主要通过腹部入路进行一期缝合。本病例报告之后讨论了新鲜右侧钝性创伤性膈肌破裂的诊断和手术治疗相关问题。