右外傷性横隔膜ヘルニアに対するMDCT多断面再構成法の有用性
Blunt traumatic rupture of the right diaphragm is very rare, and the subsequent development of diaphragmatic hernia is a serious complication. We herein report two cases of right diaphragmatic injury diagnosed by plain chest X-ray and multiplanar reformation of multi-detector law computed tomography...
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Published in | Journal of the Japanese Association for the Surgery of Trauma Vol. 32; no. 4; pp. 417 - 421 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | Japanese |
Published |
一般社団法人 日本外傷学会
20.10.2018
The Japanese Association for the Surgery of Trauma |
Subjects | |
Online Access | Get full text |
ISSN | 1340-6264 2188-0190 |
DOI | 10.11382/jjast.32.417 |
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Abstract | Blunt traumatic rupture of the right diaphragm is very rare, and the subsequent development of diaphragmatic hernia is a serious complication. We herein report two cases of right diaphragmatic injury diagnosed by plain chest X-ray and multiplanar reformation of multi-detector law computed tomography (MPR-MDCT). We performed transthoracic repair of the diaphragm, and the post-operative course was uneventful in both cases. MPR-MDCT was useful for the diagnosis of right diaphragmatic injury.
鈍的外傷による右横隔膜損傷の発生頻度はまれであるが, 外傷性横隔膜ヘルニアを合併するとより重篤な病態に陥る. 今回, 胸部レントゲン検査とマルチスライスCTの多断面再構成法により確定診断を得た右外傷性横隔膜ヘルニアの2例を経験した. いずれも開胸手術により損傷した横隔膜を修復し, 術後経過は良好であった. マルチスライスCTの多断面再構成法は右横隔膜損傷の診断に有用であった. |
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AbstractList | Blunt traumatic rupture of the right diaphragm is very rare, and the subsequent development of diaphragmatic hernia is a serious complication. We herein report two cases of right diaphragmatic injury diagnosed by plain chest X-ray and multiplanar reformation of multi-detector law computed tomography (MPR-MDCT). We performed transthoracic repair of the diaphragm, and the post-operative course was uneventful in both cases. MPR-MDCT was useful for the diagnosis of right diaphragmatic injury.
鈍的外傷による右横隔膜損傷の発生頻度はまれであるが, 外傷性横隔膜ヘルニアを合併するとより重篤な病態に陥る. 今回, 胸部レントゲン検査とマルチスライスCTの多断面再構成法により確定診断を得た右外傷性横隔膜ヘルニアの2例を経験した. いずれも開胸手術により損傷した横隔膜を修復し, 術後経過は良好であった. マルチスライスCTの多断面再構成法は右横隔膜損傷の診断に有用であった. 鈍的外傷による右横隔膜損傷の発生頻度はまれであるが, 外傷性横隔膜ヘルニアを合併するとより重篤な病態に陥る. 今回, 胸部レントゲン検査とマルチスライスCTの多断面再構成法により確定診断を得た右外傷性横隔膜ヘルニアの2例を経験した. いずれも開胸手術により損傷した横隔膜を修復し, 術後経過は良好であった. マルチスライスCTの多断面再構成法は右横隔膜損傷の診断に有用であった. |
Author | 加藤, 久晶 田中, 義人 小倉, 真治 名知, 祥 吉田, 隆浩 北川, 雄一郎 中野, 志保 白井, 邦博 豊田, 泉 |
Author_FL | TANAKA Yoshihito YOSHIDA Takahiro NACHI Sho OGURA Shinji KATO Hisaaki SHIRAI Kunihiro NAKANO Shiho KITAGAWA Yuichiro TOYODA Izumi |
Author_FL_xml | – sequence: 1 fullname: KATO Hisaaki – sequence: 2 fullname: NAKANO Shiho – sequence: 3 fullname: KITAGAWA Yuichiro – sequence: 4 fullname: TANAKA Yoshihito – sequence: 5 fullname: NACHI Sho – sequence: 6 fullname: YOSHIDA Takahiro – sequence: 7 fullname: SHIRAI Kunihiro – sequence: 8 fullname: TOYODA Izumi – sequence: 9 fullname: OGURA Shinji |
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References | 10) Marchand P : A study of the forces productive of gastro-oesophageal regurgitation and herniation through the diaphragmatic hiatus. Thorax 1957 ; 12 : 189-194. 11) Reber PU, Schmied B, Seiler CA, et al : Missed diaphragmatic injuries and their long-term sequelae. J Trauma 1998 ; 44 : 183-188. 2) Estrera AS, Landay MJ, McClelland RN : Blunt traumatic rupture of the right hemidiaphragm : experience in 12 patients. Ann Thorac Surg 1985 ; 39 : 525-530. 8) 月岡一馬 : 横隔膜破裂のメカニズム. 救急医 1990 ; 14 : 545-552. 4) Mihos P, Potaris K, Gakidis J, et al : Traumatic rupture of the diaphragm : experience with 65 patients. Injury 2003 ; 34 : 169-172. 13) Leppaniemi A, Haapiainen R : Occult diaphragmatic injuries caused by stab wounds. J Trauma 2003 ; 55 : 646-650. 14) 近藤薫, 佐藤陽子, 浦上年彦, ほか : 左外傷性横隔膜ヘルニアに対する胸腔鏡併用手術の経験. 日呼外会誌 1996 ; 10 : 82-87. 15) 宮野裕, 池田豊秀, 小山邦広, ほか : 胸腔鏡では手術が困難であった遅発性外傷性横隔膜ヘルニアの1例. 日呼外会誌 2008 ; 22 : 109-112. 7) Bergin D, Ennis R, Keogh C, et al : The dependent viscera sign in CT diagnosis of blunt traumatic diaphragmatic rupture. AJR Am J Roentgenol 2001 ; 177 : 1137-1140. 9) Gilberto RM, Rodriguez A, Shantney CH : Acute rupture of the diaphragm in blunt trauma : analysis of 60 patients. J Trauma 1986 ; 26 : 438-444. 1) Kearny PA, Rouhana SW, Burney RE : Blunt rupture of the diaphragm : mechanism, diagnosis, and treatment. Ann Emerg Med 1989 ; 18 : 1326-1330. 3) Gelman R, Mirvis SE, Gens D : Diaphragmatic rupture due to blunt trauma : sensitivity of plain chest radiographs. AJR Am J Roentgenol 1991 ; 156 : 51-57. 5) 井上卓也, 上尾光弘, 河西克介, ほか : マルチスライスCTが受傷急性期の診断に有用であった外傷性右横隔膜ヘルニアの1例. 日救急医会誌 2007 ; 18 : 820-825. 6) Rees O, Mirvis SE, Shanmuganathan K : Multidetector-row CT of right hemidiaphragmatic rupture caused by blunt trauma : a review of 12 cases. Clin Radiol 2005 ; 60 : 1280-1289. 12) 三井章, 桑原義之, 木村昌弘, ほか : 遅発性外傷性横隔膜ヘルニア嵌頓の1例. 日腹部救急医会誌 2009 ; 29 : 789-792. |
References_xml | – reference: 9) Gilberto RM, Rodriguez A, Shantney CH : Acute rupture of the diaphragm in blunt trauma : analysis of 60 patients. J Trauma 1986 ; 26 : 438-444. – reference: 1) Kearny PA, Rouhana SW, Burney RE : Blunt rupture of the diaphragm : mechanism, diagnosis, and treatment. Ann Emerg Med 1989 ; 18 : 1326-1330. – reference: 14) 近藤薫, 佐藤陽子, 浦上年彦, ほか : 左外傷性横隔膜ヘルニアに対する胸腔鏡併用手術の経験. 日呼外会誌 1996 ; 10 : 82-87. – reference: 7) Bergin D, Ennis R, Keogh C, et al : The dependent viscera sign in CT diagnosis of blunt traumatic diaphragmatic rupture. AJR Am J Roentgenol 2001 ; 177 : 1137-1140. – reference: 13) Leppaniemi A, Haapiainen R : Occult diaphragmatic injuries caused by stab wounds. J Trauma 2003 ; 55 : 646-650. – reference: 11) Reber PU, Schmied B, Seiler CA, et al : Missed diaphragmatic injuries and their long-term sequelae. J Trauma 1998 ; 44 : 183-188. – reference: 6) Rees O, Mirvis SE, Shanmuganathan K : Multidetector-row CT of right hemidiaphragmatic rupture caused by blunt trauma : a review of 12 cases. Clin Radiol 2005 ; 60 : 1280-1289. – reference: 15) 宮野裕, 池田豊秀, 小山邦広, ほか : 胸腔鏡では手術が困難であった遅発性外傷性横隔膜ヘルニアの1例. 日呼外会誌 2008 ; 22 : 109-112. – reference: 5) 井上卓也, 上尾光弘, 河西克介, ほか : マルチスライスCTが受傷急性期の診断に有用であった外傷性右横隔膜ヘルニアの1例. 日救急医会誌 2007 ; 18 : 820-825. – reference: 3) Gelman R, Mirvis SE, Gens D : Diaphragmatic rupture due to blunt trauma : sensitivity of plain chest radiographs. AJR Am J Roentgenol 1991 ; 156 : 51-57. – reference: 8) 月岡一馬 : 横隔膜破裂のメカニズム. 救急医 1990 ; 14 : 545-552. – reference: 2) Estrera AS, Landay MJ, McClelland RN : Blunt traumatic rupture of the right hemidiaphragm : experience in 12 patients. Ann Thorac Surg 1985 ; 39 : 525-530. – reference: 12) 三井章, 桑原義之, 木村昌弘, ほか : 遅発性外傷性横隔膜ヘルニア嵌頓の1例. 日腹部救急医会誌 2009 ; 29 : 789-792. – reference: 4) Mihos P, Potaris K, Gakidis J, et al : Traumatic rupture of the diaphragm : experience with 65 patients. Injury 2003 ; 34 : 169-172. – reference: 10) Marchand P : A study of the forces productive of gastro-oesophageal regurgitation and herniation through the diaphragmatic hiatus. Thorax 1957 ; 12 : 189-194. |
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Snippet | 鈍的外傷による右横隔膜損傷の発生頻度はまれであるが, 外傷性横隔膜ヘルニアを合併するとより重篤な病態に陥る. 今回, 胸部レントゲン検査とマルチスライスCTの多断面再... Blunt traumatic rupture of the right diaphragm is very rare, and the subsequent development of diaphragmatic hernia is a serious complication. We herein report... |
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SubjectTerms | diagnostic imaging multiplanar reformation right diaphragmatic rupture 右横隔膜損傷 多断面再構成法 画像診断 |
Title | 右外傷性横隔膜ヘルニアに対するMDCT多断面再構成法の有用性 |
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