Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Delayed Diagnosis of a Traumatic Diaphragmatic Injury

지연 진단된 외상성 횡격막 손상 1예

  • Park, Seon-Wook (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Cheol-Hong (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Ji-Youn (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Lee, Seung-Hwa (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Kim, Young-Wook (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Hyun, In-Gyu (Department of Internal Medicine, Hallym University College of Medicine) ;
  • Shin, Ho-Seung (Department of Thoracic and Cardiovascular Surgery, Hallym University College of Medicine)
  • 박선욱 (한림대학교 의과대학 내과학교실) ;
  • 김철홍 (한림대학교 의과대학 내과학교실) ;
  • 김지연 (한림대학교 의과대학 내과학교실) ;
  • 이승화 (한림대학교 의과대학 내과학교실) ;
  • 김용욱 (한림대학교 의과대학 내과학교실) ;
  • 현인규 (한림대학교 의과대학 내과학교실) ;
  • 신호승 (한림대학교 의과대학 흉부외과학교실)
  • Received : 2008.11.17
  • Accepted : 2009.03.10
  • Published : 2009.03.30
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Abstract

Traumatic diaphragmatic rupture is uncommon, but requires a prompt diagnosis and repair. Diaphragmatic injury is most commonly associated with automobile accidents. The diagnosis is difficult and may be delayed because there are no specific symptoms, signs, or radiographic studies that are pathognomic for diaphragmatic injury. The most important factor in the diagnosis is a high suspicion and the use of proper diagnostic studies. We report a case involving the delayed presentation of diaphragmatic rupture in a 54 year old man, requiring surgical repair 12 days following multiple blunt trauma. It should be noted that early recognition for diaphragmatic injury is important in patients with multiple trauma to avoid the potential fatal complications.

외상성 횡격막 손상은 대부분 교통사고와 관련되어 있다. 특히, 횡격막 파열은 그 진단이 지연되는 경우가 많다. 왜냐하면, 임상적 증상 및 징후가 특이적이지 않기 때문이다. 또한, 가슴 X-선 사진에서도 특징적 소견을 보이지 않으며, 더구나 동반된 다른 외상으로 인해 진단이 은폐될 수 있다. 그래서 다발성 외상 환자를 접근할 때는 횡격막 손상을 의심하고 적절한 검사를 택하는 것이 중요하다. 저자들은 교통사고로 인한 다발성 둔기외상으로 내원한 54세 남자 환자에서 입원 12 병일에 수술적 치료를 요하는 횡격막 파열을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

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References

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