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논문 기본 정보

자료유형
학술저널
저자정보
김선희 (부산대학교 의과대학 흉부외과학교실) 조정수 (부산대학교 의과대학 흉부외과학교실) 김영대 (부산대학교 의과대학 흉부외과학교실) 이호석 (부산대학교 의과대학 흉부외과학교실) 송승환 (부산대학교 의과대학 흉부외과학교실) 허업 (부산대학교 의과대학 흉부외과학교실) 김재훈 (부산대학교 의과대학 외과학교실) 박성진 (부산대학교 의과대학 외과학교실)
저널정보
대한외상학회 Journal of trauma and injury : JTI Journal of trauma and injury : JTI 제25권 제4호
발행연도
2012.1
수록면
217 - 222 (6page)

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Purpose: Diaphragmatic rupture following trauma is often an associated and missed injury. This report is about our experience with treating traumatic diaphragmatic rupture (TDR). Methods: From January 2007 to September 2012, 18 patients who had a diaphragmatic rupture due to blunt trauma or penetrating injury underwent an operation for diaphragmatic rupture at our hospital. We retrospectively reviewed their medical records, including demographic factors, initial vital signs, associated injuries, interval between trauma and diagnosis, injured side of the diaphragm, diagnostic tools, surgical method or approaches, operative time, herniated organs, complications, and mortality. Results: The average age of the patients was 43 years, and 16 patients were male. Causes of trauma included motor vehicle crashes (n=7), falls (n=7), and stab wounds (n=5). The TDR was right-sided in 6 patients and left-sided in 12. The diagnosis was made by using a chest X-ray (n=3), and thorax or upper abdominal computed tomography (n=15). Ten(10) patients were diagnosed within 12 hours. A thoracotomy was performed in 8 patients, a video-assisted thoracoscopic surgery in 4 patients, a laparotomy in 3 patients, and a sternotomy in one patient. Herniated organs were the omentum (n=11), stomach (n=8), spleen and colon (n=6), and liver (n=6). Eighteen diaphragmatic injuries were repaired primarily. Seven patients underwent ventilator care, and two of them had pneumonia and acute respiratory distress syndrome. There were no operative mortalities. Conclusion: Early diagnosis and surgical treatment determine the successful management of TDR with or without the herniation of abdominal organs. The surgical approach to TDR is chosen based on accompanying organ injuries and the injured side.

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