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Massive ipsilateral pleural effusion caused by transdiaphragmatic intercostal hernia
Young-Shun Wu1, Yen-Yue Lin, Chin-Wang Hsu
1Department of Emergency Medicine, Tri-Service General Hospital, Taipei 114, Taiwan, Republic of China.
The American Journal of Emergency Medicine
|February 15, 2008
Summary
Transdiaphragmatic intercostal hernia (TDIH) is a rare injury from blunt trauma, often diagnosed late. This case highlights delayed diagnosis and successful surgical repair of TDIH following abdominal trauma.
Area of Science:
- Trauma Surgery
- Thoracic Surgery
- Surgical Case Reports
Background:
- Transdiaphragmatic intercostal hernia (TDIH) is an uncommon condition resulting from blunt chest and abdominal trauma.
- Delayed diagnosis of TDIH can lead to significant morbidity.
Observation:
- A patient presented with massive pleural effusion and intestinal obstruction symptoms two months after a blunt abdominal injury.
- Clinical presentation suggested a delayed complication of diaphragmatic injury.
Findings:
- Multidetector-row computed tomography confirmed a traumatic diaphragm rupture and TDIH.
- Surgical intervention included thoracotomy for visceral reduction and diaphragm/chest wall repair.
Implications:
- This case underscores the importance of considering TDIH in patients with a history of blunt trauma presenting with delayed respiratory or gastrointestinal symptoms.
- Prompt diagnosis and surgical management are crucial for favorable outcomes in TDIH.
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