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相關文獻
- Traumatic Diaphragmatic Hernia with Delayed Presentation
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頁籤選單縮合
題名 | Traumatic Diaphragmatic Hernia with Delayed Presentation=慢性創傷性橫膈疝氣的延遲表現 |
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作者 | 林裕冠; 黃炳勳; 施志勳; 許文虎; 黃敏雄; 李建賢; Lin, Yu-kwang; Huang, Biing-shiun; Shih, Chih-shiun; Hsu, Wen-hu; Huaug, Min-hsiung; Lee, Chen-hsen; |
期刊 | 中華醫學雜誌 |
出版日期 | 19990400 |
卷期 | 62:4 1999.04[民88.04] |
頁次 | 頁223-229 |
分類號 | 416.22 |
語文 | eng |
關鍵詞 | 橫膈疝氣; 橫膈破裂; 胸腹部創傷; Diaphragmatic hernia; Diaphragmatic rupture; Thoracoabdominal trauma; |
中文摘要 | 背景橫膈破裂並不罕見,尤其常見於嚴重的胸腹部創傷,然而其診斷對臨床醫師 仍是個難題。若在急性期漏診,就可能發展至慢性創傷性橫膈疝氣。本研究回顧過去35年 來慢性創傷性橫膈疝氣的病例。 方法回顧性探討本院 24 例慢性創傷性橫膈疝氣的處置經驗。 結果最常見的創傷是高速車禍鈍傷,疝氣滑入左胸多於右胸,由創傷到疝氣症狀出現的時間 可以從 2 週到 40 年(平均 7.3 年)。此病常見的症狀是胸痛、呼吸急促和腸阻塞,胃和 大腸是最常見的疝脫臟器。胸部X光最實用,可診斷出 20 位病例( 83.3 %),而消化道 鋇劑造影可用於確立診斷。所有病人均接受開胸術,推出疝氣、縫合橫膈缺損。術後病人恢 復順利,沒有病例死亡。 結論對於胸腹部創傷,如一發現胸部X光有異常就必須定期追蹤。高度警惕、正確的胸部X 光判斷和早期手術是診治慢性創傷性橫膈疝氣和避免併發症的成功關鍵。對於這類病例,開 胸術得到很好的結果,僅在少數特殊情況下才須要施行剖腹術。 |
英文摘要 | BACKGROUND: Traumatic diaphragmatic rupture may occur in patients with thoracoabdominal injuries, and still poses a diagnostic challenge to surgeons. Those patients who survive the events without being diagnosed in the acute phase develop chronic traumatic diaphragmatic hernia. In this study, we reviewed cases of chronic traumatic diaphragmatic hernia managed over the past 35 years. METHODS: We retrospectively evaluated the clinical courses and radiologic images of 24 cases with chronic traumatic diaphragmatic hernia. RESULTS: Motor vehicle accident with blunt abdominal trauma was the most important mode of injury. Herniation was more common to the left plural cavity than to the right. The interval between injury and the onset of symptoms ranged from two weeks to 40 years (average, 7.3 years). Vague chest pain, shortness of breath, and bowel obstruction are the most common presentations. Chest radiographic findings suggested the diagnosis of diaphragmatic hernia in 20 patients. Barium study of the gastrointestinal tract was required to confirm the diagnosis. The most common herniated abdominal viscera were the stomach and colon. All patients received thoracotomy with reduction of hernia organs and closure of the diaphragmatic defect. The hospital course was uneventful with no operative mortality. CONCLUSIONS: Careful interpretation of radiographic images and early surgical intervention are essential in the management of patients with chronic traumatic diaphragmatic hernia. Thoracotomy with reduction of herniated organs can be performed safely with satisfactory results. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。