7 research outputs found
Post-traumatic diaphragma hernia
W niniejszym artykule przedstawiono przypadek 22-letniego m臋偶czyzny z pourazow膮 przepuklin膮 przeponow膮,
do powstania kt贸rej dosz艂o w nast臋pstwie t臋pego urazu klatki piersiowej i nadbrzusza. Na podstawie
przeprowadzonych bada艅 diagnostycznych rozpoznano pourazow膮 przepuklin臋 przeponow膮 lewostronn膮.
Chorego operowano w trybie planowym. W trakcie laparotomii stwierdzono rozerwanie lewej kopu艂y przepony,
przez kt贸re 偶o艂膮dek zosta艂 w wi臋kszej cz臋艣ci przemieszczony do klatki piersiowej. 呕o艂膮dek odprowadzono
do jamy brzusznej i wykonano plastyk臋 przepukliny pourazowej przepony, zeszywaj膮c j膮 przy rozpr臋偶onym
p艂ucu. W przebiegu pooperacyjnym wyst膮pi艂a odma op艂ucnowa lewostronna, kt贸r膮 leczono, wykonuj膮c
drena偶 lewej jamy op艂ucnowej. Drena偶 usuni臋to w 4. dobie po operacji, po uzyskaniu upowietrznienia
dolnego pola lewego p艂uca. Pacjenta wypisano z kliniki w 5. dobie po operacji w stanie dobrym.A case of a 22 year-old male with post-traumatic diaphragmatic hernia resulting from a blunt injury of
chest and epigastrium is presented. Based on diagnostic procedures, left-sided posttraumatic diaphragmatic
hernia was diagnosed. A scheduled surgical procedure was performed in the patient. A laparotomy
revealed a rupture of the left diaphragmatic dome which allowed the displacement of the major part of
the stomach to the thoracic cavity. The stomach was replaced in the abdominal cavity and a hernioplasty
was performed by suturing the diaphragm while keeping the lungs expanded. During the postoperative
course, left-sided pneumothorax occurred which was treated with left thoracic cavity drainage. The drain
was removed on the fourth day after the operation when aeration of the lower field of the left lung was
achieved. The patient was discharged in good condition on the fifth day after operation
Megacolon imitating emphysema in the course of diaphragmatic hernia
61-year old man with fever, diarrhoea, weight loss has been admitted to the hospital. Nine years earlier an air bubble in the lower part of the left lung was recognised during the chest x-ray, four years later diagnostic studies have shown a megacolon situated in the chest that significantly pressed on the flesh of the left lung and shifted the mediastinum to the right side. At that time the patient did not agree for an operation treatment. He decided for surgery in May 2002. During the operation the presence of an enormous large intestine of the megacolon type has been determined which could be found there due to diaphragm loss. The megacolon and spleen were surgically removed and the injured diaphragm was sutured. After 2 years a clinical and functional examinations of the respiratory system were performed. There was an improvement of the exercise capacity, recession of restriction in functional examinations and an increase in body mass