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KMID : 0378019750180020261
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New Medical Journal
1975 Volume.18 No. 2 p.261 ~ p.265
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Traumatic Diaphragmatic Rupture
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Abstract
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This report involves two cases of traumatic diaphragmatic rupture who were seen in this hospital during at 12 months period.
The first case, a 29 year old male, sustained stab wound in the left antero-inferior chest.
X-ray examination showed normal except for slight elevation of the left diaphragm.
Diaphragmatic rupture was diagnosed by the digital examination of the diaphragm through the
chest wound.
Immediate left antero-lateral thoracotomy was made, it was discovered that the diaphragm had ruptured in the antero-medial part and a part of greater omentum had herniated through the rent. Peritoneal cavity was explored with extesion of the wound of the diaphrngm and perforation of the
fundus of the stomach was found.
Perfortion of the stomach was closed with simple suture, the omentum was reduced and the rent of the diaphragm was closed.
The second case, a 28 year old truck driver, had, while driving, struck against a building and sustained left side multiple rib fracture with flail chest, chest wall defect, massive hemopneumothorax, right side hemopneumothorax, and rupture of the right diaphragm and liver.
Inspection and digital palpation were done on both side thoracic cavities and diaphragm through the wound of the chest wall, followed by insertion of the chest tube.
Rupture of the right diaphragm and liver was found and a part of the ruptured liver herniated into
the thoracic cavity through the rent.
Fixation of left ribs, repair of left chest wall defect, suture of the wound of the ruptured liver and diaphragm were done with bithoracotomy.
Both cases discharged after uneventful recovery.
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