PDF(Pubmed)
Abstract：
Postoperative diaphragmatic hernia (DH) following endoscopic thoracic sympathectomy for primary palmar hyperhidrosis is extremely rare. We present a 21-year-old female patient who developed a left DH with herniation of the stomach and gastric perforation on the first postoperative day after undergoing bilateral video-assisted thoracoscopic sympathectomy R4 ablation. She complained of severe dyspnea and chest pain, and an emergency chest x-ray and computed tomography revealed left pleural effusion, collapsed lung, and left DH, which allowed the stomach to herniate into the chest. Emergency thoracoscopic surgery was performed. We repaired the diaphragmatic defect intraoperatively and replaced the stomach with the peritoneal cavity from the thoracic field. The patient was discharged without complications. She did not present with recurrent symptoms at the 3-month follow-up. Postoperative DH should be considered when patients complain of gastrointestinal or respiratory symptoms after sympathectomy, although it is very rare.
摘要：
内窥镜胸交感神经切除术治疗原发性手掌多汗症后的术后膈疝（DH）极为罕见。我们介绍了一名21岁的女性患者，该患者在接受双侧电视胸腔镜交感神经切除术R4消融后的第一天出现了左DH，并出现了胃疝和胃穿孔。她抱怨严重的呼吸困难和胸痛，紧急胸部X光和计算机断层扫描显示左侧胸腔积液，萎陷的肺,离开DH,让胃突出到胸部.进行了紧急胸腔镜手术。我们在术中修复了the肌缺损，并用胸野的腹膜腔代替了胃。患者出院，无并发症。在3个月的随访中，她没有出现复发症状。当患者在交感神经切除术后抱怨胃肠道或呼吸道症状时，应考虑术后DH。虽然它是非常罕见的。
