Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Herniation of abdominal viscera into the thorax following traumatic diaphragmatic hernia can simulate acute tension pneumothorax. A case is presented of a blunt trauma victim with apparent acute diaphragmatic rupture, tension hemothorax, or tension hemopneumothorax. Nasogastric tube insertion demonstrated tension gastrothorax, but was followed by acute clinical decompensation. Percutaneous needle thoracostomy decompressed the stomach without causing spillage of gastric contents. Autopsy experimentation was performed to demonstrate that needle decompression of the distended stomach is well tolerated. Tension gastrothorax is a rare, life-threatening complication of traumatic diaphragmatic hernia. Although nasogastric tube placement should be attempted first, it may exacerbate the condition. Percutaneous needle decompression of the stomach through the chest wall can stabilize the situation and is safer and more rapid than chest tube placement, which might be either ineffective or dangerous. Paralyzing the patient with acute diaphragmatic rupture before tracheal and gastric intubation might prevent progression to tension gastrothorax.
 ...
PMID:Tension gastrothorax complicating acute traumatic diaphragmatic rupture. 162 87

A 16-year-old male presented with a hemopneumothorax following a gunshot wound to the left chest. He was treated effectively with closed suction drainage for 48 hours when he suddenly complained of severe left chest pain. Preoperative diagnosis was suggestive of a traumatic diaphragmatic hernia but operative findings were confirmatory of a rare hernia through the foramen of Bochdalek. Chest X-ray showing a gas-filled viscus above the diaphragm is diagnostic. Increased abdominal pressure generated when he was first hit by the bullet and aggravated by increased negative intrapleural pressure resulting from suction drainage of the hemothorax is the probable mechanism of the herniation.
 ...
PMID:Gunshot wound of the left chest and Bochdalek hernia. 378 83

We treated two cases of pericardial rupture from blunt chest trauma. Case 1: A 55-year-old male was injured in an automobile accident. He recovered from the left hemothorax by tube drainage. One year and two months after the trauma, a left pericardial rupture was found during an operation for a left diaphragmatic hernia. As the epicardium adhered firmly to the pericardium, the ruptured pericardium was not sutured. Case 2: A 46-year-old man fell from a tree five meters in height. Chest radiography showed multiple right rib fractures, a pelvic fracture, pneumopericardium, and right hemopneumothorax. After four days, we performed a thoracoscopic examination under local anesthesia. The thoracoscopy revealed a rupture as large as an egg in the right pericardium anterior to the phrenic nerve. Judging from the size of the rupture, cardiac luxation was suspected not to have occurred. So the defect was not repaired. These two patients were discharged uneventfully without cardiac luxation. In the future, the accumulation of thoracoscopic findings may provide adequate information for judging the indication of operative repair in pericardial ruptures.
 ...
PMID:[Two cases of pericardial rupture due to blunt chest trauma]. 805 46

We present the case of an 18-year-old man involved in a fall with blunt abdominal trauma. The patient had hypovolemic shock and findings of an acute abdomen. Initial computed tomography (CT) showed pulmonary contusion, pneumohemothorax, hemoperitoneum, hepatic contusion, right kidney laceration and vascular avulsion, rupture of the mesenteric vein, rupture of the right rectus muscle with bowel hernia, and infrarenal aortic dissection. There were no signs of limb or medullar ischemia. After hemodynamic stabilization and surgical repair of the associated lesions, the dissection was successfully treated with a self-expanding aortic Wallstent. Postprocedure CT showed a well-positioned patent stent and the patient was discharged asymptomatic. Percutaneous endovascular stent implantation is minimally invasive and seems to be a safe treatment for traumatic dissection of the abdominal aorta.
 ...
PMID:A case of acute abdominal aortic dissection caused by blunt trauma. 1673 31

In order to summarize the clinical diagnosis and treatment methods for 42 cases of multiple injuries with pancreatic injury, a retrospective analysis on 42 cases of multiple injuries with pancreatic injury from January 1990 to January 2006 was carried out in our hospital. Most cases were associated with hemopneumothorax and rib fractures (52.3%), shock (50%), multiple fractures (47.6%), and severe brain injury (26.1%). In 42 cases, one case died of severe hemorrhagic shock, and the remaining 41 cases (97.6%) were cured (including 40 cases receiving surgical operation and one case receiving the conservative treatment). Postoperative complications occurred in 16 cases (21 cases/times): pancreatic fistula (5 cases/times) and incisional wound infection (5 cases/times), intra-abdominal infection (3 cases/times), stress ulcer (3 cases/times), pleural effusion (3 cases/times), pulmonary infection (one case) and wound dehiscence (1 case). The principle therapy of multiple injuries with pancreatic injury is to rescue life, followed by active treatment to prevent injuries which giving rise to the abnormal respiratory and circulatory functions, management of cerebral hernia and other injuries which endangers life at last, and the pancreatic injury to increase the survival rate and survival quality.
 ...
PMID:Diagnosis and treatment of 42 cases of multiple injuries with pancreatic injury. 1827 65

A 30-year-old male who had suffered from the left hemopneumothorax due to the traffic accident 13 years before was admitted to our hospital suffering from abdominal pain. Computed tomography revealed the stomach was incarcerated through the left central tendon of the left diaphragm. He was diagnosed as delayed traumatic diaphragmatic hernia and emergency operation was performed via thoracic approach. Stomach and omentum, densely adhered to the lung and the chest wall, were strangulated in the left pleural cavity and hardly reducible. Stomach and omentum were reduced through the enlarged hernia and necrotized stomach was totally resected under the subsequent laparotomy. Hernia was closed directly via thoracic approach. A prompt diagnosis is necessary for a case highly suspicious of delayed traumatic diaphragmatic hernias presenting with strangulation.
 ...
PMID:[Delayed traumatic diaphragmatic hernia with strangulated stomach; report of a case]. 1846 93

A 61-year-old man was transferred to our institution because of blunt chest trauma after accidentally falling. A chest roentgenogram (CXR) and computed tomography (CT) revealed bilateral hemopneumothorax and fractures of multiple left ribs, the pelvis, and the left femur. On the second day in hospital, the patient suddenly complained of dyspnea. Emergency CXR and CT revealed elevation of the left diaphragm, suggestive of a traumatic diaphragmatic hernia; emergency surgery was performed. We confirmed rupture of the diaphragm and pericardium with cardiac herniation: the pleural pericardium and diaphragm were torn individually, and the heart and abdominal organs had herniated into the pleural cavity. They were repaired, and there were no cardiopulmonary complications during or after the operation. Pericardiodiaphragmatic rupture with cardiac herniation after multiple blunt traumas is rare. We describe the successful treatment of a diaphragmatic and pericardial rupture with cardiac herniation, with special reference to pericardial injuries.
 ...
PMID:Rupture of the diaphragm and pericardium with cardiac herniation after blunt chest trauma. 2054 60

A 77-year-old man injured himself when he fell heavily on the left side of his chest. He had massive subcutaneous emphysema, bleeding, and left hemopneumothorax. He also fractured his seventh through tenth ribs; a fragment of the ninth rib was displaced into the thoracic cavity. The severity of the damage and the patient's pain was assessed using the Abbreviated Injury Scale 1990 (1998 update) as level 3. He was treated with conservative therapy and discharged on the 16 days after the injury. However, the following day, he had acute upper abdominal pain, his blood pressure dropped to 40 s, and he was readmitted. A chest CT showed the transverse colon was prolapsed in the thoracic cavity. The patient was diagnosed as having a delayed traumatic diapharagmatic hernia. A laparoscopic repair was performed. The rupture was classified as a IIIb-type diaphragmatic injury according to the Japanese Association for the Surgery of Trauma's classification system. It is believed that a fragment of a fractured rib that had been displaced in the thoracic cavity ruptured the diaphragm sharply. Since traumatic diapharagmatic hernia rarely occurs, it is relatively difficult to diagnose at the first examination. This condition has a high mortality rate because of the associated injuries. Surgery is the only treatment, but it should only be considered after a second examination. Herein, I report my experience with a case of delayed diaphragmatic hernia repaired by laparoscopic surgery.
 ...
PMID:Delayed left traumatic diaphragmatic hernia repaired by laparoscopic surgery. 2277 8