medigraphic.com
ISSN 1727-897X (Electronic)

2019, Number 4

<< Back Next >>

Medisur 2019; 17 (4)

Left thoraco-abdominal wound as a cause of diaphragmatic hernia. Presentation of three cases

Lombardo VTA, de Quesada SL, Meléndez EA

Language: Spanish
References: 15
Page: 570-577
PDF size: 267.08 Kb.


ABSTRACT

Injuries caused by white arms in the thoraco-abdominal region have the potential to damage both anatomical cavities: thorax and abdomen, with the subsequent injury of the diaphragm muscle and the production of a visceral hernia, associated or not with visceral injury. In case this clinical entity is overlooked, there is a high probability of life-threatening complications; therefore, adequate management is a challenge for the general surgeon, who needs a high index of suspicion to formulate the diagnosis. Three cases of victims of assault with a perforating-cutting weapon in the left thoraco-abdominal region are presented, attended in facilities where limited diagnostic resources were available. Clinical data, diagnostic support tests, surgical procedure, postoperative course and progress are explained. The abdominal surgical approach is the gold rule for repairing the injured diaphragm, and the minimal thoracostomy is effective when there is thoracic involvement.


REFERENCES

  1. Mesa D, Hidalgo M, Cabrera FA, Pérez A, Fernández Z. Heridas de la región toracoabdominal. Rev Cub Med Mil [revista en Internet]. 2011 [ cited 20 Ene 2019 ] ; 40 (3-4): [aprox. 8p]. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext& pid=S0138-65572011000300007&lng=en&nrm= iso&tlng=es.

  2. Vargas I. Hernia diafragmática postraumática. Revista Médica de la Universidad de Costa Rica [revista en Internet]. 2014 [ cited 4 Abr 2019 ] ; 8 (1): [aprox. 24p]. Available from: https://revistas.ucr.ac.cr/index.php/medica/article /view/14977/14235.

  3. Thiam O, Konate I, Gueye ML, Seck M, Cisse M, Diop B, et al. Traumatic diaphragmatic injuries: epidemiological, diagnostic and therapeutic aspects. Springerplus. 2016 ; 5 (1): 1614.

  4. Voeller GR, Reisser JR, Fabian TC, Kudsk K, Mangiante EC. Blunt diaphragm injuries. A five-year experience. Am Surg. 1990 ; 56 (1): 28-31.

  5. Kishore A, Singh A, Jain A. Traumatic diaphragmatic hernia: a case report. Int Surg J. 2018 ; 5 (6): 2378-82.

  6. Fawzy A, Eldin MM, Mahmoud A, Elmakarem A. Rupture diaphagm: Early diagnosis and management. JESCTS. 2017 ; 25 (2): 163-70.

  7. Zafar SN, Rushing A, Haut ER, Kisat MT, Villegas CV, Chi A, et al. Outcome of selective non-operative management of penetrating abdominal injuries from the North American National Trauma Data base. Br J Surg. 2012 ; 99 Suppl 1: S155-64.

  8. López Y, Fernández A, Sánchez E. Evaluación de criterios para laparotomía en lesiones abdominales por arma blanca. Rev Cubana Cir [revista en Internet]. 2016 [ cited 12 Ene 2019 ] ; 55 (1): [aprox. 12p]. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext& pid=S003474932016000100001&lng=es.

  9. Yücel M, Özpek A, Tolan HK, Başak F, Baş G, Ünal E, et a. Importance of diagnostic laparoscopy in the assessment of the diaphragm after left thoracoabdominal stab wound: A prospective cohort study. Ulus Travma Acil Cerrahi Derg. 2017 ; 23 (2): 107-11.

  10. Koshi O, Satoshi F, Ryo I, Takayuki K, Kanna O, Kohei T, et al. Massive hemothorax due to two bleeding sources with minor injury mechanism: a case report. J Med Case Rep. 2018 ; 12 (1): 291.

  11. Ahmad F, Nabi G, Chowdhary MA, Lone H. The Characteristics and Surgical Approach in Post-Traumatic Diaphragmatic Hernia: A Single Center Experience. Bull Emerg Trauma. 2013 ; 1 (3): 108-11.

  12. Abdelghany A, Abu Arab W, Allam A, Karara K. Emergency thoracotomy: Experience of one tertiary trauma center. JESCTS. 2016 ; 24 (2): 188-93.

  13. Al-Thani H, Jabbour G, El-Menyar A, Abdelrahman H, Peralta R, Zarour A. A Descriptive Analysis of Right and Left-sided Traumatic Diaphragmatic Injuries; Case Series from a Single Institution. Bull Emerg Trauma. 2018 ; 6 (1): 16-25.

  14. Testini M, Girardi A, Isernia RM, De Palma A, Catalano G. Emergency surgery due to diaphragmatic hernia: case series and review. World J Emerg Surg. 2017 ; 12: 23.

  15. Jain SA. Traumatic Diaphragmatic Hernia. J Surg [revista en Internet]. 2018 [ cited 12 Ene 2019 ] ; 04: [aprox. 8p]. Available from: https://www.gavinpublishers.com/admin/assets/a rticles_pdf/1527512555article_pdf820774196.pdf.




2020     |     www.medigraphic.com