Right upper quadrant pain after previous blunt abdominal trauma: undiagnosed traumatic diaphragmatic hernia with strangulated right colon.

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL
Robert Young, Rajarshi Mukherjee
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引用次数: 0

Abstract

A woman in her 40s self-presented to an emergency department in a major trauma centre with severe right-sided abdominal pain, a tender right upper quadrant mass and chest pain. Diagnostic imaging showed a previously undiagnosed diaphragmatic hernia containing strangulated right colon. The patient had been the victim of a high-energy road traffic accident 18 months earlier, but at that time had not presented to hospital or undergone any outpatient investigation. This emergency presentation necessitated an emergency laparotomy, right colectomy, suture repair of diaphragmatic hernia and formation of ileo-colostomy. While a small number of similar cases have been documented, right-sided traumatic diaphragmatic herniae (TDH), where abdominal viscera bypass the liver and subsequently strangulate, are exceedingly rare. The evidence on delayed diagnosis of TDH is discussed and a system of follow-up for patients who suffer blunt abdominal trauma which is managed non-operatively is suggested.

既往钝性腹部创伤后右上腹部疼痛:未确诊的外伤性膈疝伴右结肠绞窄。
一名40多岁的妇女因严重的右腹部疼痛、右上腹肿块和胸痛而来到一家大型创伤中心的急诊科。诊断影像显示先前未确诊的膈疝,包含绞窄的右结肠。该患者是18个月前一次高能道路交通事故的受害者,但当时未到医院就诊或接受任何门诊检查。这一紧急表现需要紧急剖腹手术,右结肠切除术,膈疝缝合修复和形成回肠结肠造口术。虽然有少量类似的病例记录,但右侧外伤性膈疝(TDH)是非常罕见的,腹部脏器绕过肝脏并随后绞窄。讨论了TDH延迟诊断的证据,并建议对遭受钝性腹部创伤的患者进行非手术治疗的随访系统。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMJ Case Reports
BMJ Case Reports Medicine-Medicine (all)
CiteScore
1.40
自引率
0.00%
发文量
1588
期刊介绍: BMJ Case Reports is an important educational resource offering a high volume of cases in all disciplines so that healthcare professionals, researchers and others can easily find clinically important information on common and rare conditions. All articles are peer reviewed and copy edited before publication. BMJ Case Reports is not an edition or supplement of the BMJ.
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