• 제목/요약/키워드: Traumatic hernia

검색결과 36건 처리시간 0.019초

지연성 외상성 횡격막 탈장 (Delayed Presentation of Traumatic Diaphragmatic Hernia)

  • 황경환;황이두;오덕진;김재학;나명훈;유재현;임승평;이영
    • Journal of Chest Surgery
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    • 제31권2호
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    • pp.162-167
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    • 1998
  • 저자들은 1976년 1월 부터 1997년 3월 까지 21년간 외상성 횡격막 파열 52례 중 지연성 외상성 횡격막 탈장 6례를 치험 하였는데 이중 남자는 4례, 여자는 2례였으며 우측은 1례였다. 둔상에 의한 경우는 5례였고 자상은 1례였다. 수술은 모두 개흉술을 시행 하였고 복부로 절개를 연장한 경우가 1례 있었다. 외상성 흉부 손상을 입었을 때 횡격막 파열을 의심하는 것이 중요하며 흉강경을 이용하여 진단및 치료를 할 수 있다.

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외상성 횡격막 헤르니아: 3례 수술 보고 (Traumatic Diaphragmatic Hernia: A Report of 3 Cases)

  • 유세영
    • Journal of Chest Surgery
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    • 제2권1호
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    • pp.59-64
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    • 1969
  • Three cases of traumatic diaphragmatic hernia were repaired in this department from June 1967 to Nov.1968. The first case, a 14 year old girl, was diagnosed as diaphragmatic hernia during the operation of the diffuse peritonitis from jejunaI perforation 3 days after the traffic accident at local clinic and she was transfered to this hospital after the closure of the perforated jejunum. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture at the posterolateral portion of the left diaphragm was repaired with two layer sutures by transthoracic approach. The second case. a 26 year old man. was diagnosed immediately after the traffic accident at local clinic and transfered to this hospital 24 hours later. Herniated and distended stomach, transverse colon and jejunum were repositioned and the large diaphragmatic rupture, about 9 cm in length, from the posterolateral portion to the base of the pericardium was directly repaired with two layer sutures. The third case, a 26 year old man, who had a history of stab wound at left lower lateral chest two years ago,was admitted with the sudden onset of abdominal pain and vomiting. The diaphragmatic hernia was confirmed with barium enema. The herniated stomach and transverse colon through the defect, about 3.5 cm in diameter, at anterolateral portion of the left diaphragm, were repositioned and the defect was repaired with two layer sutures. All of the cases recovered uneventfully.

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성인에서 횡격막마비로 오인한 우엽간 횡격막탈장 1예 (Diaphragmatic Hernia of the Right Hepatic Lobe Mistaken for Diaphragmatic Paralysis in Adult)

  • 박정현;황기은;김소영;김학렬;양세훈;김휘정;정은택
    • Tuberculosis and Respiratory Diseases
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    • 제68권5호
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    • pp.298-300
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    • 2010
  • Diaphragmatic paralysis can be demonstrated through diaphragmatic elevation on chest X-ray after thoracic lung surgery or the placement of chest tubing. Additional causes of diaphragmatic paralysis are iatrogenic, mass, atelectasis, etc. For the diagnosis of diaphragmatic paralysis, it required some studies (fluoroscopy, computed tomography [CT], magnetic resonance imaging). Diaphragmatic hernia of the liver is a rare clinical entity, usually found after trauma in adults. Congenital diaphragmatic hernia in neonates requires surgery. Non-traumatic diaphragmatic hernia of the liver in an adult is a rare right-sided diaphragmatic hernia. On developing any symptoms, surgery must be performed. When diaphragmatic hernia is incidentally found in adults without trauma, it is placed under observation for a time period. We diagnosed the diaphragmatic herniation of a right hepatic lobe by 16-slice CT scan without surgery.

외상성 횡경막 탈장: 5례 수술 보고 (Traumatic Diaphragmatic Hernia: A Report of 5 Cases)

  • 장순명
    • Journal of Chest Surgery
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    • 제7권2호
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    • pp.163-168
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    • 1974
  • Five cases of traumatic diaphragmatic hernia were repaired in the Department of Thoracic Surgery, Seoul National University Hospital, during the period from 1967 to 1974. The first case, a 14-year aid girl, was diagnosed as diaphragmatic hernia during laparotomy because of jejunal perforation 3 days after traffic accident. Herniated stomach, transverse colon, spleen and left lobe of the liver were repositioned and the diaphragmatic rupture on left posterolateral portion was repaired with two layers of nonabsorbable sutures by transthoracic approach. The second case, a 26-year old man,was diagnosed immediately after traffic accident at a local clinic and transferred to this hospital 24 hours later. Herniated stomach, transverse colon and jejunum were repositioned amd diaphragmatic rupture,about 9 cm in length,from the posterolat.edge to the base of pericardium was sutured in two layers. The third case, a 26-year old man who had stab wound on the left lower lateral chest two years ago,was admitted with sudden abdominal pain and vomiting. Upper gastrointestinal series with barium meal revealed diaphragmatic hernia. The herniated stomach and transverse colon through the defect,about 3.5cm in diameter, at anterolateral portion on the left side,were repositioned and repaired with two layers of nonabsorbable sutures. The forth case, a 26-year old man, sustained blunt trauma to the chest by a roller and was transferred to the emergency room complaining of dyspnea 40 minutes after the accident. The diaphragmatic rupture extended from left midaxillary line to contralateral anterior axillary line,about 20cm long, at anterior portion of diaphragm, which was repaired with two layers, of nonabsorbable sutures. The fifth case, a 4-year old girl, had two separate diaphragmatic ruptures on both sides, which were caused by traffic accident. Immediate upper gastrointestinal series after injury showed herniated stomach, colon and spleen into left Chest cavity. Another small rupture with anterior edge of right lobe of the liver in chest cavity was noted. These were repaired with non-absorbable sutures via thoracotomy.

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외상성 횡경막 허니아 (Traumatic Diaphragmatic Hernia)

  • 장봉현;한승세;김규태
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.839-846
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    • 1987
  • The records of 10 patients with traumatic diaphragmatic hernia seen from November 1977 through July 1987 were reviewed. All the patients had a transdiaphragmatic evisceration of abdominal contents into the thorax. We treated 7 male and 3 female patients ranging in age from 3 to 62 years. In 8 patients, diaphragmatic hernia followed blunt trauma and in 2 patients, stab wounds to the chest. The herniation occurred on the right side in 3 patients and on the left side in 7. All the patients sustained additional injuries: rib fractures [7 patients], additional limb, pelvic and vertebral fractures [6], closed head injury [2], lung laceration [1], liver laceration [1], renal contusion [1], ureteral rupture [1], and splenic rupture [1]. Organs herniated through the diaphragmatic rent included the omentum [6 patients], stomach [4], liver [4], colon [3], small intestine [1], and spleen [1]. For right-sided injuries, the liver was herniated in all 3 patients and the colon, in 1. in the initial or latent phase, dyspnea, diminished breath sounds, bowel sounds in the chest were noted in 4 patients, and in the obstructive phase, nausea, vomiting, and abdominal pain were found in all 3 patients. Two patients had a diagnostic chest radiograph with findings of bowel gas patterns, and an additional 8 had abnormal but nondiagnostic studies. Hemothorax, pleural effusion or abnormal diaphragmatic contour were common abnormal findings. Three patients were operated on during the initial or acute phase [immediately after injury], 4 patients were operated on during the latent or intermediate phase [3 to 210 days], and 3 patients were operated on during the obstructive phase [10 to 290 days]. Six patients underwent thoracotomy, 2 required thoracoabdominal incision, and 2 had combined thoracotomy and laparotomy. Primary suture was used to repair the diaphragmatic hernia in 9 cases. One patient required plastic repair by a Teflon felt. Empyema was the main complication in 2 patients. In 1 patient, the empyema was treated by closed thoracostomy and in 1, by decortication and open drainage. There were no deaths.

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Diaphragmatic Hernia with Stomach Rupture after Blunt Chest Trauma at a Short Interval: A Case Report

  • Lee, Seung Hyong;Lee, Sun-Geun;Kim, Dae Hyun;Cho, Sang-Ho;Song, Jae Won;Park, Won Kyoun
    • Journal of Chest Surgery
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    • 제55권1호
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    • pp.85-87
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    • 2022
  • Diaphragmatic hernias have been reported in 0.8%-1.6% of patients who experience blunt chest trauma. The hernia is assumed to form as a result of direct diaphragmatic violation or significant intraabdominal or intrathoracic pressure caused by the trauma. Some reports have described cases of delayed diaphragmatic hernia and subsequent stomach perforation that occurred a few days to several years after an accident. We report an extremely rare case of diaphragmatic herniation in which the process from initial blunt trauma to visceral organ perforation took only 2 days, without any evidence of herniation on the initial X-ray or computed tomography. Delayed diaphragmatic herniation and subsequent visceral organ perforation should not be missed during the period immediately after blunt chest trauma.

외상성 횡격막 파열의 지연성 발현 (Delayed Presentarion of Traumatic Diaphragmatic Rupture)

  • 설영훈;문재영;이경하;이상일;전광식;이준완;송인상
    • Journal of Trauma and Injury
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    • 제27권2호
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    • pp.38-42
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    • 2014
  • Traumatic diaphragmatic rupture is quite uncommon and rarely lethal injury. However, delayed presentation between the injury and the diagnosis can cause a life-threatening condition with various complications such as intestinal hernia, obstruction, strangulation, respiratory distress. Here, we present a case of delayed presentation of traumatic diaphragmatic rupture in a 51-year-old man, and then discuss about the clinical implication of delayed presentation of diaphragmatic rupture with a review.

Diaphragmatic hernia in a Jeju horse (crossbred) broodmare

  • Yang, Jaehyuk;Koh, Yang-Nam;Hwang, Kyu-Kye;Lim, Yoon-Kyu
    • 대한수의학회지
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    • 제49권4호
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    • pp.351-354
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    • 2009
  • Diaphragmatic hernias, whether congenital or acquired (traumatic), are rarely observed in the horse. Acquired diaphragmatic hernias typically occur secondary to trauma or an increase in intraabdominal pressure due to falling, heavy exercise, or parturition. Diaphragmatic herniorrhaphy is difficult to perform in adult horses and the horses with symptomatic diaphragmatic hernias usually die. A 10- year old, 340 kg, Jeju horse (crossbred) broodmare with sudden onset of gait disorder and a moderate emaciation was examined. Findings on physical examination included conjunctivitis, dehydration, shallow breathing, dyspnea, weaken heart beat, lack of auscultatable sounds from the gastrointestinal tract, and anorexia. Rectal temperature was $38.4^{\circ}C$ and respiratory rates were moderately increased. There were slight signs of acute colic. The broodmare died one day after non-specific treatment of fluids, nutriment, antibiotics and non-steroidal anti-inflammatory drug. The cause of death was strangulation of the small intestine through a diaphragmatic hernia. The rent was about 2 cm in diameter and located in the central right part of diaphragm. Around 60 cm of small intestine was protruded into thoracic cavity through the rent. The cause of the hernia could not be ascertained. The broodmare had been pastured with many other horses, and the groom had not noticed any aggressive behavior among them. It was, however, speculated that trauma by stallion's attack may have been the cause of the diaphragmatic hernia, because the new horse may be the object of behaviors ranging from mild threats to seriously aggressive kicking, squealing, rearing, and biting.

후천성 폐탈출증 -2례 보고- (Accluired Herniation of Lung a report of two cases)

  • 한일용;이양행;황윤호
    • Journal of Chest Surgery
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    • 제30권11호
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    • pp.1145-1148
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    • 1997
  • 폐탈출증은 근골격으로 구성된 흉곽 밖으로 폐실질이 빠져나와 돌출되는 것으로, 최근까지 문헌으로 보고된 예는 300 례 미만이다. 환자는 늑골 골절을 포함한 외상을 입었던 과거력을 가진 37세와 57세 남자 이며 주소는 전흉부에 무통성의 부드러운 종괴로 호기시나 기침시 그 크기가 증가하였고, 흡기시 혹은 조용한 호흡시에는 감소하였다. 수술은 흉벽 결손에 대한 일차 봉합술을 시행하였으며, 술후 재발은 아직 까지 관찰되지 않았다 저자들은 지금까지 국내 발생보고 예가 없는 후천성 폐탈출증 2례를 수술 치험하였기에 문헌고찰과 함께 보고하는 바이다.

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Comparison of Penetrating and Blunt Traumatic Diaphragmatic Injuries

  • Lee, Sang Su;Hyun, Sung Youl;Yang, Hyuk Jun;Lim, Yong Su;Cho, Jin Seong;Woo, Jae Hyug
    • Journal of Trauma and Injury
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    • 제32권4호
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    • pp.210-219
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    • 2019
  • Purpose: Traumatic diaphragmatic injury (TDI) is no longer considered to be a rare condition in Korea. This study investigated differences in the prevalence of accompanying injuries and the prognosis in patients with traumatic diaphragmatic damage according to the mechanism of injury. Methods: We retrospectively reviewed the medical records of patients with TDI who were seen at a regional emergency medical center from January 2000 to December 2018. Among severe trauma patients with traumatic diaphragmatic damage, adults older than 18 years of age with a known mechanism of injury were included in this study. Surgery performed within 6 hours after the injury was sustained was defined as emergency surgery. We assessed the survival rate and likelihood of respiratory compromise according to the mechanism of injury. Results: In total, 103 patients were analyzed. The patients were categorized according to whether they had experienced a penetrating injury or a blunt injury. Thirty-five patients had sustained a penetrating injury, and traffic accidents were the most common cause of blunt injuries. The location of the injury did not show a statistically significant difference between these groups. Severity of TDI was more common in the blunt injury group than in the penetrating injury group, and was also more likely in patients with respiratory compromise. However, sex, the extent of damage, and the initial Glasgow coma scale score had no significant relationship with severity. Conclusions: Based on the findings of this study, TDI should be recognized and managed proactively in patients with blunt injury and/or respiratory compromise. Early recognition and implementation of an appropriate management strategy would improve patients' prognosis. Multi-center, prospective studies are needed in the future.