• Journal of Chest Surgery
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• 제26권9호
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• pp.730-734
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• 1993

Three neonates with congenital diaphragmatic eventration underwent intrathoracic operation had marked improvements in symptoms postoperatively. Two were one day of ages, one was 1 month of age, and they were all female and had other congenital abnormalities of lung hypoplasia, cleft palate, nasal polyps and neonatal hepatitis. The right diaphragm was more affected than left as 2:1. The repair for diaphragmatic eventration was performed successfully by plication of remnant diaphragm, and there were no complications postoperatively.

• Journal of Chest Surgery
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• 제28권9호
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• pp.837-841
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• 1995

Between June 1981 and April 1994, 15 patients underwent surgical repair of diaphragmatic hernia. The ages ranged from 1 day to 60 years, with a mean age of 34. There were 5 cases of congenital diaphragmatic hernia; Bochdalek hernia in 4 cases and Morgagni hernia in 1 case. There were 10 cases of traumatic diaphragmatic hernia;blunt trauma in 8 cases and stab wounds in 2 cases. The chest X-ray findings were abnormal in 10 cases. Operations were performed in all patients and there was only one death, who was a newborn with left Bochdalek hernia and pulmonary hypoplasia.

• Journal of Chest Surgery
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• 제28권12호
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• pp.1197-1200
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• 1995

Since diaphragmatic injuries are difficult to diagnose, those that missed may present with latent symptoms.Delayed diaphragmatic hernia is very rare and occurs commonly after penetrating or blunt trauma. Recently we had experience with two cases of delayed diaphragmatic hernia after left nephrectomy.They were operated by herniolysis and closure of diaphragm using prosthetic patch[Dura, Dacron through the left thoracotomy. Postoperative courses were uneventful.

• Journal of Trauma and Injury
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• 제36권1호
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• pp.56-59
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• 2023

Traumatic diaphragmatic hernia is among the most uncommon conditions after severe trauma, and it is associated with high morbidity and mortality. The diagnosis is difficult and might be missed, but a multimodal investigation might help in terms of diagnostic yield. In this case report, we present a missed right diaphragmatic rupture 14 years after the trauma.

• 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.

• 한국임상수의학회지
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• 제26권1호
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• pp.62-68
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• 2009

A diaphragm is a musculotendinous partition that separates abdominal and thoracic organs and assists in ventilation. Three dogs were presented after being hit by a car, and one dog was presented with the history of respiratory problems including intermittent dyspnea and coughing. Survey thoracic radiography, positive contrast celiography and sonography revealed traumatic diaphragmatic hernia in three dogs and congenital peritoneopericardial diaphragmatic hernia in one dog. In three dogs including a dog with congenital peritoneopericardial diaphragmatic hernia, herniorrhaphy was performed. Among the three dogs underwent surgery, two dogs with traumatic diaphragmatic hernia recovered uneventfully. However the dog with congenital peritoneopericardial diaphragmatic hernia died from pulmonary edema at 2 days after surgery. Positive-contrast ceilography and ultrasonography provides to investigate the integrity of the diaphragm. Chronic diaphragmatic hernia and concurrent injuries are considered as prognostic factors.

• 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.

• Journal of Chest Surgery
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• 제54권1호
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• pp.59-64
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• 2021

Background: Diaphragmatic injuries following blunt or penetrating thoraco-abdominal trauma are rare, but can be life-threatening. Rib fractures are the most common associated injury in patients with a traumatic diaphragmatic injury (TDI). We hypothesized that the pattern of rib fracture injuries could dictate the likelihood of acute TDIs. Methods: A retrospective study was carried out between April 2014 and October 2018 to analyze patients with TDIs and rib fractures at a major trauma center in London, United Kingdom. Results: Over the study period, 1,560 patients had rib fractures, of whom 14 had associated diaphragmatic injuries. Left-sided diaphragmatic injuries were found in 8 patients (57%). A significant proportion of the rib fractures were located posterolaterally (44.9%). The highest frequency of fractures was found in ribs 5-10, which accounted for 74% of all the fractures. Ten patients underwent surgery, of whom 7 were diagnosed with a diaphragmatic injury intraoperatively after video-assisted thoracoscopic surgery assessment of the pleural cavity. Two patients died due to severe injuries of other organs and the remaining 2 patients were managed conservatively. Conclusion: Our series of patients demonstrates a relationship between significant rib fractures and diaphragmatic injuries in trauma patients, and the diagnostic difficulties in identifying the condition. We found that the location of the rib fractures and the pattern of injury in patients with TDIs were much lower and posterolateral in the chest wall without a preference for laterality. We suggest using a thoracoscope in patients undergoing chest wall surgery post-trauma to aid in diagnosing this condition.

• 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 Chest Surgery
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• 제37권9호
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• pp.813-816
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• 2004

외상성 횡격막 파열은 방사선 검사로 진단하기가 어려운 경우가 빈번하다. 다발성 손상을 동반한 37세 남자 환자에서 횡격막 파열이 의심되었으나, 흉부 CT 검사에서는 횡격막 파열을 확인할 수는 없었고 진단을 위해 흉강경을 이용한 수술을 결정하였다. 횡격막 신경이 횡격막으로 들어가는 부위로부터 8 cm정도의 횡격막 파열이 있었고, 횡격막 마비를 동반하였다. 작업창을 5 cm크기로 추가하여 만든 후, 파열된 횡격막을 연속 봉합하였으며, 동시에 횡격막 주름성형술을 시행하였다. 수술 3개월후 시행한 흉부 방사선 사진에서 만족할 만한 결과를 보였다.