Traumatic Diaphragmatic Hernia: Report of two Cases
作者
Wei-Yu Chiu, Jane-Yi Hsu
卷期/出版年月
39卷2期 (2006/4)
頁次
100-105
摘要
Traumatic diaphragmatic hernia (TDH) can be difficult to recognize. We present 2
cases of TDH. One case is a 23-year-old man, who suffered from a blunt injury with
acute TDH from a motor vehicle accident. The other case is a 60-year-old male who
had chronic TDH due to a violent penetrating injury more than 20 years previously.
Immediate herniation is most often associated with a large tear of the diaphragm, but
the symptoms of the herniation are usually obscured by other associated injuries. The
diaphragmatic repair should be approached through a laparotomy due to the high
incidence of simultaneous intra-abdominal organ injury. If small tears of the
diaphragm are not repaired initially, progressive abdominal visceral herniation may
occur because of the pressure gradient between the thoracic and peritoneal cavities. A
thoracotomy provides excellent exposure to divide the adhesions between the trapped
viscera and lung parenchyma. We emphasize that there are two types of TDH: acute
and chronic. Each of these two types has its own treatment modality.