• Journal of Chest Surgery
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• v.27 no.8
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• pp.643-649
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• 1994

We evaluated sixteen patients of traumatic diaphragmatic injuries that we have experienced from Jan. 1987 to Aug 1993. Age was ranged from 6 to 71 years, predominantly in the fourth and fifth decades. 13 were male and 3 were female, a ratio of 4.3: 1. Blunt trauma was develped in 11 [Lt 7, Rt 4], penetrating trauma in 5 [Lt 2, Rt 3]. Preoperative diagnosis of diaphragmatic injury was possible in 8 patients [72.2 %] in blunt trauma, and 1 patient [20 %] in penetrating trauma. 8 cases[54.5%] in blunt trauma, and 4 cases in penetrating trauma were treated within 24 hours,meanwhile, patients treated after 10 days were 3, all by blunt trauma.The repair of 16 cases were performed with thoracic approach in 4 cases, thoracoabdominal approach in 3 cases, and abdominal approach in 9 cases. The herniated organs in thorax were stomach [5], colon [3], liver [2], and pancreas [1]. Postoperative complication were developed in 9cases[56.3%] significantly related with delayed operation time [p < 0.01 ]. Hospital mortality was 12.5 % [2/16], and the causes of death were hypovolemic shock in one and hepatic failure due to portal vein rupture in another.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.47-50
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• 2019

Thoracic splenosis is a rare disease that develops as a result of autotransplantation of splenic tissue into the thoracic cavity following splenic and diaphragmatic injury. We report the case of a 53-year-old man with a chief complaint of heartburn and cough. He had a history of traumatic diaphragmatic rupture treated with surgical repair and splenectomy 15 years ago. Imaging studies revealed a paraesophageal mass, and surgical resection was performed considering the possibility of Castleman disease or an esophageal submucosal tumor. Pathologic results showed findings of normal splenic tissue. The patient was discharged on postoperative day 5 without any complications.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.258-260
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• 2023

Traumatic rupture of the right hemidiaphragm occurred following a high-velocity motor vehicle collision in the case presented herein. The resulting herniation of small bowel loops into the thorax resulted in hemodynamic and respiratory compromise due to pressure effects on the right heart and major vessels. The patient's hemodynamic status improved with reduction of enterothorax, and the diaphragmatic defect was repaired. We discuss the available literature and learning points from this rare case.

• Journal of Veterinary Clinics
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• v.31 no.6
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• pp.531-534
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• 2014

A 3-year-old intact mixed hunting dog was referred to Gyeongsang Animal Medical Center with the clinical signs of vomiting, dyspnea, anorexia. The dogs had traumatic history that wounded at abdominal wall during the wild boar hunting 2 week ago. The dogs was diagnosed as extrahepatic biliary tract obstruction (EHBO) secondary to traumatic hernia. Diagnosis was based on radiographic features of a diaphragmatic hernia on survey radiography, dilated bile duct in abdominal ultrasonography and complete recovery due to the return of displaced organs into the peritoneal cavity and repair of the diaphragmatic rent. Diagnostic imaging and surgical intervention may result in a favorable outcome in dog with post hepatic obstruction secondary to diaphragmatic hernia. This case emphasizes the strangulation of bile duct by diaphragmatic rupture could be the cause of EHBO.

• Journal of Chest Surgery
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• v.29 no.11
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• pp.1257-1262
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• 1996

From January 1989 to February 1996, 50 patients with a traumatic diaphragmatic rupture were treated at the Yonsei University Wonju College of Medicine. There were 40 male and 10 female patients. The ages ranged from 2 to 80 years, with peak incidence in third decades. Thirty-nine cases had blunt trauma (traffic accident 29, falls down 7, others 3), and 11 cases had penetrating injuries (stab injury 9, gun shot 1, broken glass 1). The most common symptoms were dyspnea (76%), chest pain (58%), and abdominal pain (52%). In blunt trauma, the rupture was located in the left in 30 cases, right in 9 cases and in penetrating trauma, the rupture was located in the left in 8 cases and in the right in 3 cases. Eighteen cases underwent thoracotomy alone, 29 cases underwent laparotomy only and 3 cases had combined thoracotomy and laparotomy. The postoperative mortality occurred in 6% (3 cases), and the cause of death were septic shock (1), intracranial hemorrhage (1), and respiratory failure (1).

• Proceedings of the Korean Society of Veterinary Clinics Conference
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• 2008.05a
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• pp.135-135
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• 2008

• Journal of Trauma and Injury
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• v.19 no.2
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• pp.201-205
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• 2006

Tension viscerothorax (gastrothorax) is rare life-threatening disease which is caused by air trapped in viscera. A distended viscera in the hemi-thorax shifts the mediastinal structures and causes extra-cardiac obstructive shock. A defective diaphragm is caused by abdominal trauma or a congenital anomaly. Traumatic diaphragmatic injury can be missed until herniation develops several years after blunt trauma. In our case, a 10-year old boy developed hemodynamic compromise in the emergency department. Three years earlier, he had suffered blunt abdominal trauma during a pedestrian traffic accident, but there was no evidence of diaphragmatic injury at that time. He was successfully resuscitated by gastric decompression and an emergent thoracic operation. The operation finding revealed a traumatic diaphragmatic injury. Tension viscerothorax is a rare, but catastrophic, condition, so we suggest that addition of tension viscerothorax to the Advanced Trauma and Life Support (ATLS) guidelines may be helpful.

• Journal of Chest Surgery
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• v.50 no.6
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• pp.424-429
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• 2017

Background: The surgical treatment of secondary spontaneous pneumothorax (SSP) can be complicated by fragile lung parenchyma. The preoperative prediction of air leakage could help prevent intraoperative lung injury during manipulation of the lung. Common sites of bulla development and ruptured bullae were investigated based on computed tomography (CT) and intraoperative findings. Methods: The study enrolled 208 patients with SSP who underwent air leak control through video-assisted thoracoscopic surgery (VATS). We retrospectively reviewed the sites of bulla development on preoperative CT and the rupture sites during VATS. Results: Of the 135 cases of right-sided SSP, the most common rupture site was the apical segment (31.9%), followed by the azygoesophageal recess (27.4%). Of the 75 cases on the left side, the most common rupture site was the apical segment (24.0%), followed by the anterior basal segment (17.3%). Conclusion: The azygoesophageal recess and parenchyma along the cardiac border were common sites of bulla development and rupture. Studies of respiratory lung motion to measure the pleural pressure at the lung surface could help to determine the relationship between cardiogenic and diaphragmatic movement and bulla formation or rupture.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.323-327
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• 1976

Eleven cases of traumatic diaphragmatic injuries were treated at the department of Surgery from Jan. 1972 to Nov. 1976 were reviewed in this study. 1. Sex ratio of the observed patients was 10 : 1 showing definitely high incidence male patients. 2. The age distribution in this series ranged from 4 to 49 years of age, and average age was 26 years age. 3. Seven cases were received blunt injury on lower chest and upper abdomen, three cases were stabbed by knife and gunshot injury case was on case 4. Six cases were diagnosed and treated early post-traumatic stage within 24 hours, three cases were repaired within I0 days, and the last case was repaired after 5 years post-trauma. 5. The operative mortality was 10% (1/10), the cause of death was liver failure, after right lobectomy of the liver for traumatic liver rupture.

• Journal of Chest Surgery
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• v.21 no.2
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• pp.307-315
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• 1988

A clinical analysis was performed on 97 cases of chest injuries experienced at Department of Thoracic and cardiovascular Surgery, Armed Forces Capital Hospital during 2 years period from 1986 to 1988. Of 97 patients of chest trauma, 39 cases were result from penetrating injuries whereas 58 cases were from non-penetrating injuries, and there were 77 cases of hemothorax and / or pneumothorax, 47 of rib fracture, 8 of foreign body, 6 scapular and clavicle fracture, 5 of diaphragmatic injuries, 4 of paraplegia. The majority of chest injuries were encounted in the age group between 21 and 30 years-old, mean age was 25.9 years-old and all cases were male except one. Gun-shot wound was the most common cause in the penetrating injuries and the majority of non-penetrating chest injury patients were traffic accident and fist or kick accounted for next. The principles of therapy for chest trauma were rapid expansion of the lung by closed thoracostomy[45 cases] and thoracentesis only[3 cases] but thoracotomy done at 27 cases because of massive bleeding or intrapleural hematoma, foreign body, cardiac injury, diaphragmatic injury and bronchial rupture. The over-all mortality was 2.07 percent[2 cases among all], a case was from penetrating injuries and another was from non-penetrating injuries.