복부둔상 후 발생한 긴장성 내장흉 1례

A Case of Tension Viscerothorax : A Rare Complication of Diaphragmatic Rupture after Blunt Abdominal Trauma

  • 박맹렬 (울산대학교 의과대학 서울아산병원 응급의학과) ;
  • 이재호 (울산대학교 의과대학 서울아산병원 응급의학과) ;
  • 안지윤 (울산대학교 의과대학 서울아산병원 응급의학과) ;
  • 오범진 (울산대학교 의과대학 서울아산병원 응급의학과) ;
  • 김원 (울산대학교 의과대학 서울아산병원 응급의학과) ;
  • 임경수 (울산대학교 의과대학 서울아산병원 응급의학과)
  • Park, Maeng Real (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Lee, Jae Ho (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Ahn, Ji Yoon (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Oh, Bum Jin (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Won (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Lim, Kyoung Soo (Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center)
  • 투고 : 2006.10.31
  • 심사 : 2006.11.21
  • 발행 : 2006.12.30

초록

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.

키워드

참고문헌

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