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hepatothorax due to a right diaphragmatic rupture related to duodenal ulcer perforation

World Journal of Gastroenterology 2012年第39期18卷 5649-5652页

作者： Se-Jin Baek Jin Kim Sung-Ho Lee Department of Surgery Korea University Anam HospitalSeoul 136-705South Korea Department of Thoracic Surgery Korea University Anam HospitalSeoul 136-705South Korea

Here, we present the case of a 53-year-old man with a hepatothorax due to a right diaphragmatic rupture related to duodenal ulcer perforation. On admission, the patient complained of severe acute abdominal pain, with physical examination findings suspicious for a perforated peptic ulcer. Of note, the patient had no history of other medical conditions or recent trauma, and the initial chest radiography and laboratory findings were not specific. A subsequent abdominal computed tomography revealed intrathoracic displacement of the liver, gallbladder, transverse colon and omentum through a right diaphragmatic defect. The patient then underwent an explorative laparotomy that confirmed duodenal ulcer perforation. A primary repair of the duodenal perforation was performed, and the diaphrag-matic defect was repaired using a polytetrafluoroeth-ylene patch after the organs were reduced and the cavity irrigated. This particular case proves interesting as right-sided spontaneous diaphragmatic ruptures are very rare and difficult to diagnose. Additionally, the best treatment for such large diaphragmatic defects is still controversial, especially in cases of intrathoracic or intra-abdominal contamination.

关键词： Diaphragmatic rupture hepatothorax Du-odenal ulcer perforation Polytetrafluoroethylene mesh

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Post-Traumatic Right Diaphragmatic Hernia with hepatothorax

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Open Journal of Thoracic Surgery 2018年第1期8卷 1-5页

作者： Elias Amorim Frederico Berniz Aragao Armando Veiga Alexandre Porto Galdez Head of Thoracic Surgery Service of the Maranhense Medical Center Sao LuisBrazil Thoracic Surgeon of Maranhense Medical Center Sao LuisBrazil

Introduction: Traumatic right diaphragmatic hernia is an extremely rare entity, given the protection afforded by the liver. Clinical Case: A 51-year-old women who suffered a road-traffic accident presented with a heavy sensation and several episodes of moderate pain in the left hemithorax. Physical and radiological exams revealed a traumatic right hernia. Discussion: The diagnosis of hernia should be established as quickly as possible to reduce morbidity and mortality. Treatment of the injury is always surgical and outcome is invariably positive. Conclusion: The diagnosis of diaphragmatic hernia should always be considered in patients suffering road-traffic accidents to allow early diagnosis and successful treatment.

关键词： Traumatic Diaphragmatic Hernia Thoracic Surgery Traumatology hepatothorax

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