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J Korean Soc Emerg Med > Volume 8(4); 1997 > Article
Journal of The Korean Society of Emergency Medicine 1997;8(4): 624-630.
Two Cases of Diaphragmatic Injuries Diagnosed by Thoracoscopy
Jin Yong Jeong, Kuhn Park
ABSTRACT
The diaphragmatic injury results from blunt or penetrating thoracoabdominal trauma. The diagnosis of diaphragmatic injury is difficult in the immediate postinjury period and is often delayed by late visceral herniation. Accurate diagnosis of diaphragmatic injuries is important, because overlooked and delayed diagnosis commonly lead to incarceration and strangulation of bowel. Despite of various diagnostic methods, the diagnosis is often missed and delayed. The development of video-assisted thoracoscopy can make it possible to diagnose the diaphragmatic injury safely and accurately. We experienced two cases of diaphragmatic injuries diagnosed by thoracoscopy. In first case, We found the rupture of the right diaphragm with herniation of liver in a 33-year-old female by thoracoscopic examination. She had visited Emergency Room, complaining of abdominal and pelvic pain and mild dyspnea after traffic accident. Chest X-ray showed elevation of the right hemidiaphragm. Chest CT and ultrasonogram revealed no abnormality except for diaphragmatic elevation. Another case was a 24-year-old female with laceration of diaphragm by stab wound on the left lower chest. With suspicion of diaphragmatic injury, thoracoscopic examination was performed. Both patients were successfully treated by a repair of injured diaphragm by approach via thoracotomy. The postoperative courses were uneventful.
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