DOI QR코드

DOI QR Code

Missed Traumatic Rupture of the Diaphragm

  • Ryu, Sang Woo (Department of Thoracic and Cardiovascular Surgery, Mokpo Hankook Hospital) ;
  • Chekar, Jaykey (Department of Thoracic and Cardiovascular Surgery, Mokpo Hankook Hospital) ;
  • Yi, In Ho (Department of Thoracic and Cardiovascular Surgery, Mokpo Hankook Hospital) ;
  • Seo, Bo Ra (Department of Neurosurgery, Mokpo Hankook Hospital) ;
  • Park, Seong Huek (Department of Surgery, Mokpo Hankook Hospital) ;
  • Go, Seong Ju (Department of Surgery, Mokpo Hankook Hospital)
  • 투고 : 2016.09.21
  • 심사 : 2017.01.31
  • 발행 : 2017.03.31

초록

A 48-year-old man came to the emergency department with altered consciousness and hemoperitoneum following a pedestrian traffic accident. He underwent immediate emergency laparotomy, and on the second day, he required craniectomy because of increase of intracranial hemorrhage. A chest radiograph taken 7 days after admission, showed elevation of the right hemi-diaphragm, and follow-up chest CT showed a right-sided rupture of the diaphragm, which was surgically repaired. Rupture of the diaphragm can be easily overlooked and the diagnosis delayed, especially in unstable patients with multiple trauma or altered level of consciousness, as in the case reported here.

키워드

참고문헌

  1. Scharff JR, Naunheim KS. Traumatic diaphragmatic injuries. Thorac Surg Clin 2007; 17: 81-5. https://doi.org/10.1016/j.thorsurg.2007.03.006
  2. Kim YW, Ah SH, Ryu SY, Kim HY, Jeon BM. Clinical evaluation of traumatic diaphragmatic injury. J Korean Soc Traumatol 2001; 14: 108-18.
  3. Wirbel RJ, Mutschler W. Blunt rupture of the right hemidiaphragm with complete dislocation of the right hepatic lobe: report of a case. Surg Today 1998; 8: 850-2
  4. Rashid F, Chakrabarty MM, Singh R, Iftikhar SY. A review on delayed presentation of diaphragmatic rupture. World J Emerg Surg 2009; 4: 32-8. https://doi.org/10.1186/1749-7922-4-32
  5. Hanna WC, Ferri LE, Fata P, Razek T, Mulder DS. The current status of traumatic diaphragmatic injury: Lessons learned from 105 patients over 13 years. Ann Thorac Surg 2008; 85: 1044-8 https://doi.org/10.1016/j.athoracsur.2007.10.084
  6. Rodriguez-Morales G, Rodriguez A, Shatney CH. Acute rupture of the diaphragm in blunt trauma: analysis of 60 patients. The Journal of trauma 1986; 26: 438-44. https://doi.org/10.1097/00005373-198605000-00005
  7. Mihos P, Potaris K, Gakidis J, et al. Traumatic rupture of the diaphragm: experience with 65 patients. Injury 2003; 34:169-72. https://doi.org/10.1016/S0020-1383(02)00369-8
  8. Guth AA, Pachter HL, Kim U. Pitfalls in the diagnosis of blunt diaphragmatic injury. Am J Surg 1995; 170: 5-9 https://doi.org/10.1016/S0002-9610(99)80242-6
  9. Mihos P, Potaris K, Gakidis J, et al. Traumatic rupture of the diaphragm: experience with 65 patients. Injury 2003; 34: 169-72. https://doi.org/10.1016/S0020-1383(02)00369-8
  10. Barkin AZ, Fischer CM, Berkman MR, et al. Blunt abdominal trauma and a diaphragmatic injury. J Emerg Med 2007; 32: 113-7. https://doi.org/10.1016/j.jemermed.2006.11.001
  11. Burgess AR, Eastridge BJ, Young JW, et al: Pelvic ring disruptions: effective classification system and treatment protocols. J Trauma 1990; 30: 848-56. https://doi.org/10.1097/00005373-199007000-00015