• 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.

• Journal of Trauma and Injury
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• 제29권2호
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• pp.43-46
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• 2016

Traumatic diaphragmatic injury (TDI) occurs in 1% of patients of blunt abdominal trauma. Most TDIs involve the left diaphragm, however the authors experienced TDI accompanied by a liver laceration of the right diaphragm. When detected early, TDI can be easily treated, however serious complications can occur if not. When diaphragmatic injury is suspected due to clinical manifestation, comprehensive analysis of the patient data including radiologic findings is important.

• Journal of Trauma and Injury
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• 제36권3호
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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 Chest Surgery
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• 제22권2호
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• pp.364-370
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• 1989

22 Cases of traumatic diaphragmatic injuries treated at the Department of Thoracic and Cardiovascular Surgery in Chon-Buk National University Hospital from Jan. 1979 to Oct. 1988 were reviewed in this study. Of the 22 cases, 18 were male and 3 were female, a ratio of 4.5:1. This ratio revealed high incidence in male patient. The age distribution ranged from 2 to 60 years and mean age was 31 years. The modes of injury were as follows: 11 stab wound, 5 traffic accident, 2 fall down, 2 fighting injury, 1 compression wound by sand bag, and 1 slip down injury. Useful diagnostic tools were chest X-ray with or without radiopaque dye swallowing, which was the most commonly diagnostic, UGI series, and thoracoscope. Operations were performed in 22 cases, and 18 cases were through thoracotomy. The herniated organs through the ruptured diaphragm were stomach, omentum, liver, spleen, colon, and small bowel. There were associated injuries, and the most commonly associated was rib fracture. There was no postoperative death.

• Journal of Chest Surgery
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• 제52권1호
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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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• 제19권2호
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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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• 제28권3호
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• pp.308-312
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• 1995

A 5-year retrospective study of 14 patients with diaphragmatic injuries revealed 9 blunt and 5 penetrating injuries. In the blunt trauma group, 7 were left and 2 were right side. The penetrating diaphragmatic wound consist of 3 left and 2 right sided. Sex ratio was 11: 3, with male predominanace. Preoperative diagnosis was possible in 9 cases and delayed diagnosis [greater than 24 hours occured in 5 cases.Simple chest X-ray was diagnostic or highly suggestive in 7 cases. 7 cases were diagnosed diaphragmatic injuries by computed tomography, fiuroscopy or by explorative operation. All of the cases had association injury. 11 cases of diaphragmatic ruptures were corrected through thoracotomy and 3 cases needed exploratory laparotomy. One death occured after operation due to associated injuries and respiratory failure. Blunt and penetrating diaphragmatic injuries remain a diagnostic challenge and associated injuries, delayed diagnosis determine the outcome.

• Journal of Trauma and Injury
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• 제28권2호
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• pp.79-82
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• 2015

Simple rib fracture is one of most common injury after blunt thoracic trauma found in approximately 7% to 40% of cases. Delayed traumatic diaphragmatic injury with massive hemothorax after rib fracture is rare but a potentially life-threatening condition. We present a rare case of a 79-year-old male with delayed diaphragmatic injury with massive hemothorax due to fracture of the lower ribs. Under thoracoscopy, hemothorax was evacuated, diaphragmatic rupture was identified and repaired, and the lower ribs were fixed with metal plate (s). Although simple lower rib fractures may be the only clinical finding, close observation and monitoring are required because of the possibility of diaphragmatic and/or intraabdominal organ injury.

• Journal of Chest Surgery
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• 제30권4호
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• pp.402-407
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• 1997

1986년 3월부터 1995년 3월까지 본 마산삼성 병원 흉부외과에서 경험한 총 28례의 외상성 횡 경 막 손상 환자를 분석 하였다. 들상에 의한 경우가 20례, 자상인 경우가 8례로서 둔상인 경우 1)례가 좌측, 자상인 경우 5례가 좌측으로 전반적으로 좌측이 우측보다 많았다. 대부분 다발성 손상을 동반하였으며 모든 예에서 흉통, 호흡곤란, 복통 등의 소견을 관찰할 수 있었고 내원당시 응급실에서 횡경막 파열을 의심할 수 있었던 경우는총25례로서 흉부X선 20례 UGI 3례, 폐쇄식 흉관 삽관식 손가락으로 파열공의 직접 확인이 2례 였다. 수술적 접근은둔상의 경우개흉술이 16례,개흉복술이 1례,개복술이 I례며,관통상의 경우는개흉술 3례, 개복술이 5례로서 수상후부 터 수술까지의 경과시간은 5시간 이내가 19례였다. 좌측 손상시 12례에서 위장이 늑막강내로 올라가 있었으며, 모든 결손은 비홉수성 봉합사를 사용하여 직접 단순 봉합을 하였으며, 술후 5례에서 패혈증, 저혈성 쇽크, 두부손상, 신부전 으로 술후 3일이내 사 망하였다.

• Journal of Chest Surgery
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• 제32권4호
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• pp.394-398
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• 1999

배경: 외상에 의한 횡격막 파열은 사회환경의 변화로 점차 증가하는 추세이며 이 질환의 조기발견 및 치료에 대한 많은 연구가 행하여지고 있다. 이에 저자들은 횡경막파열로 수술을 받은 환자를 대상으로 후향적 조사를 하여 조기발견 및 치료에 도움을 얻고자 본 연구를 시작하였다. 대상 및 방법: 1994년 1월부터 1998년 4월까지 본원 흉부외과교실에서 술전 및 술후 외상성 횡경막파열로 진단 받은 20례의 환자를 대상으로 하여 술전 임상양상과 진단율, 동반질환 및 술후 합병증 등을 조사하였다. 결과: 사회활동력이 왕성한 연령의 남성에서 많이 발생하였으며 둔상 75%, 관통상 25%이었다. 좌측횡경막파열 16례(80%), 우측 3례(15%), 양측 1례(5%)였으며 증상으로는 흉통 및 호흡곤란이 가장 많았다. 술전 진단은 10례(50%)에서 가능하였으며 술중 진단 6례(30%), 만기 진단 4례(20%)였다. 술후 창상감염이 가장 많은 합병증이었으며, 사망은 2례가 있었다. 결론: 외상 후 조속한 진단을 위해 임상증상 및 흉부 단순촬영상 이상소견이 의심되면 지속적인 관찰과 검사가 필요하며 동반질환의 치료를 위해 관련된 과간의 협조가 필수적이라고 사료된다.