外傷性橫膈膜疝氣合併肝臟突出

Traumatic Diaphragmatic Hernia of Liver

張錚(Cheung Chang) ； 李三剛(San Kang Lee)

《中華放射線醫學雜誌》 11卷4期 (1986/12) Pp. 345-348

摘要

外傷性橫膈膜疝氣，多因腹部鈍傷造成腹膜與胸腔問壓力差急劇增加所致。最常見原因多半車禍或摔傷，但有時外傷較輕病人常不易記起。橫膈膜大裂傷常有急性症狀發生，而小裂傷漸進性疝氣有時沒有症狀，通常左側發生佔大多數(90%)，右側橫膈膜疝氣合併肝臟突出，常易誤為肺內腫塊，以電腦斷層、超音波或核子醫學檢查，應很容易得到診斷。

並列摘要

Traumatic rupture of the diaphragm from blunt trauma is due to a sudden explosive increase in the pleuroperitoneal pressure gradient. The usual cause is falling or automible accident, but occasionally, the traumatic event is too minor to be recalled. Large laceration may induce acute symptoms while small tear allows gradual herniation with a latent stage. The proportion of left-sided rupture is grater than 90%. The traumatic diaphragmatic hernia of liver is rare which always has radiograph commonly shown a soft tissue ”mass” at right lower lung. In the past, chest fluoroscopy and pneumoperitoneum have been recommended for diagnosis, but may lead to respiratory embarrssment. Recently, the examination of CT, Ultrasound, or Nuclear scan may provide more precisely and non-invasively for diagnosis.