This is an automatically translated article.
Rupture, perforation of the diaphragm is a type of injury that loses integrity of the diaphragm that occurs when a patient has a blunt abdominal trauma, often due to an accident. This is a high impact injury that causes abdominal pressure to rise suddenly, the diaphragm is stretched and ruptured.
1. What is a diaphragmatic perforation?
Diaphragm perforation is the total injury of the diaphragm area due to injury to the thoracic - abdominal region. Injury to the abdomen is the most likely cause of death. If not detected and treated promptly, it can be life-threatening.
2. What is the main cause of diaphragmatic perforation?
From the area of the diaphragm perforation, the viscera in the abdomen can enter the chest immediately after the accident or after the accident for a while, causing a diaphragmatic hernia.
Thủng cơ hoành sẽ khiến các tạng ở bụng chui lên lồng ngực
3. Diagnostic signs of diaphragmatic perforation?
Perforation of the diaphragm often has signs: Pain in the nasopharynx, digestive juices, bile, omentum, intestinal loops... in the chest wall wound.
When the internal organs in the abdomen come out through the hole in the diaphragm into the chest, it will cause compression of the organs in the chest, causing the patient to suffer acute asphyxia, cyanosis, arrhythmia, etc. It is possible that intestinal obstruction is caused by obstruction of the bowel loops at the diaphragmatic perforation.
With trauma to the diaphragm, the patient is more likely to have a ruptured left diaphragm.
All cases of patients with diaphragmatic perforation are indicated for surgery to suture the diaphragmatic tear. If the perforation is large, it may need to be patched with artificial materials. In case, if the doctor suspects that there is an abdominal injury, he will have an indication of laparotomy to handle the lesions. At the same time, suture the diaphragmatic puncture. If there is only a simple diaphragmatic perforation, the chest can be opened to suture the perforation. Open thoracotomy is easier to suture than laparotomy.
Phẫu thuật khâu vết thủng cơ hoành từ ngực dễ tiến hành hơn
4. Surgical procedure to suture rupture, perforation of diaphragm due to trauma
Position: Place the patient in supine positionMethod: General anesthesia, intubation.
Incision: Open the abdomen with the white line above the navel.
General examination of the abdomen:
Probe peritoneal fluid: The upper mesentery layer of the transverse colon: Includes liver, spleen, omentum omentum, body, and tail of the pancreas. Lower mesenteric layer of transverse colon: Examine transverse colon, small intestine, and mesentery from the ileocecal angle upwards
Kiểm tra tổng quát ổ bụng trước phẫu thuật
If the patient has damage to the diaphragm:
Herniated organ: Bring back to the abdomen, Check the pleural space, lung and diaphragm rupture, treat if the lung parenchyma is damaged. Perform pleural lavage if purulent, digestive, pseudomembranous, or blood clots are present. Place a pleural drain on the same side of the lesion at the V intercostal space, treat the chest wall wound if any. Sew the diaphragm with a single layer of squeegee or separate stitches with non-absorbable sutures. Place drainage depending on the location of the diaphragm and the involved organs. Any questions that need to be answered by a specialist doctor as well as if you want to be examined and treated at Vinmec International General Hospital, you can contact Vinmec Health System nationwide or register online. online HERE.
