González SG, Cepero NM, Collera RSA

Language: Spanish
References: 18
Page: 324-331
PDF size: 266.86 Kb.

ABSTRACT

A 47 years-old male patient, who was injured in a car accident in 1991 and suffered lumbar column fracture that left as a sequel a postraumatic flaccid paraparesia with neurological lesion of L5 segment, reduction of muscle strength and sensitivity in lower limbs. He had plaster for 6 months and was surgically treated in that year. He underwent fixation and osteosynthesis with metal material. During several years, he went to rehabilitation program and finally achieved good muscle strengthening. In November 2008, he began feeling intense pain at hypochondrium and right hemithorax at night and also moderate dyspnea. On the physical exam, it was confirmed that there was increase of lower third of right hemithorax and hydroaerial noises were heard. Chest x-ray using posteroanterior view was performed, which revealed increase of right hemidiaphragm and images compatible with intestinal loop in the lower third of this hemithorax. Right traumatic diaphragmatic hernia was diagnosed. This is an infrequent disease due to the shock-absorbing effect of the liver. He was medically treated and one hour later, the pain ceased. Hernia was reduced spontaneously, which was confirmed in the posterior chest x-ray. He was further operated on electively and the final result was favorable.

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