假性创伤后膈疝的诊断与治疗特点

N. I. Bogomolov, A. Kashafeeva
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摘要

胸和/或腹部的闭合性和开放性创伤会造成膈穹隆损伤,随后形成假膈疝(FDH)。在这种情况下,腹腔的活动器官被腹膜壁所覆盖,移动到胸膜腔,并在膈上有一个小的缺陷,可被侵犯到器官壁坏死。这种病理的罕见发生,临床症状的缺乏,解释了诊断的高错误率,特别是在初级卫生保健。我们在两间诊所有34年治疗12名外佣的经验。10名患者的左穹窿受损,2名患者的右穹窿受损。隔膜损伤的年龄从几小时到7年不等。五个临床实例提出,结合疾病的晚期诊断,诊断的困难,甚至在诊所使用现代成像工具。所有病人都按照计划和紧急情况进行手术。只有2例患者使用内镜手术技术进行诊断和治疗。2例(16.67%)患者死于假性膈疝,原因是创伤性和失血性休克背景下的严重闭合性损伤。结论。清楚地解释了胸部和腹部皮肤疤痕的起源,澄清了https://panor.ru/articles/osobennosti-diagnostiki-i-lecheniya-lozhnykh-posttravmaticheskikh-diafragmalnykh-gryzh/92437.html闭合损伤的机制和严重程度
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Features of diagnosis and treatment of false post-traumatic diaphragmatic hernias
Damage to the diaphragm domes followed by the formation of false diaphragmatic hernias (FDH) occurs with closed and open trauma to the chest and/or abdomen. In this case, the mobile organs of the abdominal cavity, being uncovered by the parietal peritoneum, move to the pleural cavity and, with a small defect in the diaphragm, can be infringed up to necrosis of the organ wall. The rare occurrence of such pathology, the paucity of clinical symptoms, explains the high error rate in diagnosis, especially in primary health care. We have experience in two clinics over 34 years in the treatment of 12 patients with FDH. The left dome was damaged in 10 patients, the right dome in two. The age of damage to the diaphragm ranged from several hours to 7 years. Five clinical examples are presented, combined with the late diagnosis of the disease, the difficulties of diagnosis, even in a clinic using modern imaging tools. All patients are operated on both as planned and as an emergency. Endovideosurgical technologies for diagnosis and treatment are used only in 2 patients. 2 (16.67 %) patients died with a false diaphragmatic hernia due to a severe closed injury against the background of traumatic and hemorrhagic shocks. Conclusions. A clear explanation of the origin of scars on the skin of the chest and abdomen, clarification of the mechanisms and severity of closed injuries in the https://panor.ru/articles/osobennosti-diagnostiki-i-lecheniya-lozhnykh-posttravmaticheskikh-diafragmalnykh-gryzh/92437.html
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