PDF(Pubmed)
Abstract：
Post-traumatic diaphragmatic injuries can present as diaphragmatic hernia with herniation of abdominal viscera into the thoracic cavity. It is challenging for trauma surgeons to identify the delayed presentation of post-traumatic diaphragmatic injuries which require a high index of suspicion in patients who are at risk. We report a rare case of delayed diagnosis and management of post-traumatic diaphragmatic hernia in a polytrauma patient with a concise review of the literature. The patient presented after two years of post-traumatic thoracoabdominal injury due to a road traffic accident with breathing difficulty. On investigations, it was a large diaphragmatic hernia with herniation of abdominal contents into the left thoracic cavity. Laparotomy was performed with a reduction of abdominal contents from the left side of the chest along with mesh repair of the large diaphragmatic hernia. Postoperatively, the patient recovered well. The literature suggests that there should be a high level of suspicion of diaphragmatic injuries, especially when dealing with thoracoabdominal trauma or polytrauma patients. Post-traumatic diaphragmatic injuries, though rare, can lead to high morbidity or mortality if not treated on time.
摘要：
创伤后膈肌损伤可表现为膈疝，腹部内脏疝进入胸腔。对于创伤外科医师来说，确定创伤后diaphragm肌损伤的延迟表现是一项挑战，这需要对有风险的患者有很高的怀疑指数。我们报告了一例罕见的多发性创伤患者创伤后膈疝的延迟诊断和治疗，并对文献进行了简要回顾。由于道路交通事故导致呼吸困难，该患者在创伤后胸腹受伤两年后出现。关于调查，这是一个巨大的膈疝，腹部内容物突出到左胸腔。进行了剖腹手术，从胸部左侧减少了腹部内容物，并进行了大型膈疝的网片修复。术后,病人恢复得很好。文献表明，应该高度怀疑膈肌损伤，尤其是在处理胸腹外伤或多发性外伤患者时。创伤后膈肌损伤,虽然罕见，如果不及时治疗，可能导致高发病率或死亡率。
