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1.
Sports Med Arthrosc Rev ; 29(3): e24-e33, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34398119

RESUMO

Meniscus surgery is one of the most commonly performed orthopedic procedures worldwide. Modifiable risk factors for meniscus injury include body mass index, participation in athletics and occupation. Nonmodifiable risk factors include age, sex, lower extremity alignment, discoid meniscus, ligamentous laxity, and biconcave tibial plateau. Conditions commonly associated with meniscal injury are osteoarthritis, anterior cruciate ligament injury, and tibial plateau fractures. Tear type and location vary by patient age and functional status. Surgical management of meniscus injury is typically cost-effective in terms of quality-adjusted life years. The purpose of this review is to provide an overview of meniscal injury epidemiology by summarizing tear types and locations, associated conditions, and factors that increase the risk for meniscal injury. The economic burden of meniscus injury and strategies to prevent injury to the meniscus are also reviewed.


Assuntos
Lesões do Menisco Tibial/epidemiologia , Grupo com Ancestrais do Continente Africano , Fatores Etários , Lesões do Ligamento Cruzado Anterior/complicações , Traumatismos em Atletas/etiologia , Índice de Massa Corporal , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Traumatismos Ocupacionais/etiologia , Osteoartrite do Joelho/complicações , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Ruptura/epidemiologia , Ruptura/etiologia , Fatores Sexuais , Fumar/efeitos adversos , Fraturas da Tíbia/complicações , Lesões do Menisco Tibial/economia , Lesões do Menisco Tibial/etiologia , Lesões do Menisco Tibial/terapia
2.
Sports Med Arthrosc Rev ; 29(3): 158-167, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34398121

RESUMO

The importance of the menisci in providing joint stability and their role in load transmission within the knee are well understood. A growing body of literature has emerged on 2 distinct injury patterns to these crucial anatomic structures, ramp lesions and root tears. Ramp lesions may be characterized as tears at the posterior meniscocapsular junction, while root tears involve bony or soft tissue avulsion of the meniscal insertions at the anterior or posterior intercondylar regions. In this 2-part review, we present an overview of the current available literature on ramp lesions and meniscal root tears, summarizing the unique anatomic considerations, etiology, biomechanics, management decisions, clinical outcomes pertinent to these very distinct injuries.


Assuntos
Lesões do Menisco Tibial , Lesões do Ligamento Cruzado Anterior/complicações , Artroscopia , Fenômenos Biomecânicos , Humanos , Imageamento por Ressonância Magnética , Ilustração Médica , Meniscos Tibiais/anatomia & histologia , Meniscos Tibiais/diagnóstico por imagem , Fatores de Risco , Ruptura/diagnóstico por imagem , Ruptura/etiologia , Ruptura/reabilitação , Ruptura/cirurgia , Lesões do Menisco Tibial/diagnóstico por imagem , Lesões do Menisco Tibial/etiologia , Lesões do Menisco Tibial/reabilitação , Lesões do Menisco Tibial/cirurgia
3.
J Cardiothorac Surg ; 16(1): 163, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34099017

RESUMO

BACKGROUND: CORKNOT® facilitates a reduction in cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time and operative time, but reported to be associated with other complications. We aim to quantify the incidence of valvular complications related to CORKNOT® and determine the feasibility of its use between different valvular surgeries. METHODS: Patients who underwent heart valve repair or replacement surgery via the use of automated titanium suture fasteners (CORKNOT®) in a tertiary care hospital were included in the study. This single-centre retrospective study was conducted on 132 patients between January 2016 and June 2018. RESULTS: In our study, the overall mean operative time was 320.0 ± 97.0 min, mean CPB time was 171.4 ± 76.0 min and the calculated mean ACC time was 105.9 ± 54.0 min. Fifty-eight patients (43.9%) underwent minimally invasive valve replacement or repair surgery and 66 patients (50.0%) underwent concomitant procedures. A total of 157 valves were operated on, with 112 (84.8%) single valve surgeries, 15 (11.4%) double valve surgeries and 5 (3.8%) triple valve surgeries. After reviewed by the cardiologist blinded towards the study, we report trivial and/or mild paravalvular leak (PVL) in immediate post-operative echocardiography was found in 1 (1.01%) patients. There were no reported cases of valvular thrombosis, leaflet perforation, device dislodgement or embolization, moderate and/or severe PVL during hospitalization and follow-up echocardiography within 1 year. Single mitral valve and aortic surgeries had comparable incidences of post surgical complications. CONCLUSION: We conclude the feasibility of CORKNOT® utilisation in mitral and aortic valve surgeries. Additionally, incidence of CORKNOT® related complications in heart valve repair or replacement surgery is less usual in our setting than previously reported. These results motivate the use of CORKNOT® as a valid alternative with complete commitment.


Assuntos
Doenças das Valvas Cardíacas/cirurgia , Implante de Prótese de Valva Cardíaca/instrumentação , Valvas Cardíacas/lesões , Complicações Intraoperatórias/etiologia , Complicações Pós-Operatórias/etiologia , Ruptura/etiologia , Técnicas de Sutura/efeitos adversos , Adulto , Idoso , Estudos de Viabilidade , Feminino , Seguimentos , Doenças das Valvas Cardíacas/diagnóstico , Doenças das Valvas Cardíacas/epidemiologia , Doenças das Valvas Cardíacas/etiologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Implante de Prótese de Valva Cardíaca/métodos , Valvas Cardíacas/cirurgia , Humanos , Incidência , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/epidemiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Ruptura/diagnóstico , Ruptura/epidemiologia , Técnicas de Sutura/instrumentação , Titânio , Resultado do Tratamento
4.
J Cardiothorac Surg ; 16(1): 129, 2021 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-33985533

RESUMO

BACKGROUND: Our goal was to discuss the treatment for rupture of contralateral mainstem bronchus during uniportal video-assisted thoracoscopy surgery (uniportal VATS) lobectomy. CASE PRESENTATION: We analyzed clinical data of 3 cases of rupture of contralateral mainstem bronchus during uniportal VATS. Surgical repair was performed immediately under an uniportal VATS during operation, as a result, 3 cases of bronchial rupture all were repaired successfully, and we continued to complete lobectomy and systemic lymph node dissection. Reexamination was performed after 1 week, and no fistula was found in trachea and bronchi through a fiberoptic bronchoscopy. The time range for indwelling the chest tube is 6-9 days, and the hospital stay is 8-10 days. No abnormality was observed on chest radiography when the 3 patients returned to the hospital 1 month after the operation for the second reexamination. CONCLUSIONS: Instant surgical repair is recommended to the treatment of bronchial rupture in thoracic surgery. It is safe and feasible to repair bronchial tear with uniportal VATS.


Assuntos
Brônquios/lesões , Complicações Intraoperatórias/cirurgia , Intubação Intratraqueal/efeitos adversos , Pneumonectomia/efeitos adversos , Ruptura/cirurgia , Cirurgia Torácica Vídeoassistida/efeitos adversos , Idoso , Brônquios/cirurgia , Feminino , Humanos , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/etiologia , Pessoa de Meia-Idade , Pneumonectomia/métodos , Fatores de Risco , Ruptura/etiologia , Cirurgia Torácica Vídeoassistida/métodos
5.
Knee ; 30: 35-40, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33836302

RESUMO

In this article we report a case of stiff, neglected extreme recurvatum knee deformity in a 17-year-old female. This is the first reported case in the literature of an acquired ligamentous stiff extreme knee recurvatum following manipulation under anesthesia and botulinum neurotoxin injection. Μodified Judet quadricepsplasty combined with Ilizarov external hinged frame fixation was implemented. This dual technique can be considered as a rational approach for such an extreme deformity as it stabilizes, progressively corrects, and prevents recurrence. A patellar tendon rupture caused by the increasing tension of the extensor mechanism following the correction was treated successfully using a cadaveric Achilles tendon allograft.


Assuntos
Anestesia/efeitos adversos , Toxinas Botulínicas/efeitos adversos , Joelho/fisiopatologia , Joelho/cirurgia , Procedimentos Ortopédicos/métodos , Tendão do Calcâneo/transplante , Adolescente , Toxinas Botulínicas/administração & dosagem , Feminino , Humanos , Técnica de Ilizarov , Joelho/diagnóstico por imagem , Ligamento Patelar/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Ruptura/etiologia , Ruptura/terapia , Traumatismos dos Tendões/etiologia , Traumatismos dos Tendões/cirurgia , Transplante Homólogo/métodos
6.
J Hand Surg Asian Pac Vol ; 26(2): 301-304, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33928843

RESUMO

A 68-year-old man with a right distal radius fracture treated with volar locking plate fixation previously was unable to flex his right thumb and four fingers without experiencing any adverse event. The flexor pollicis longus was reconstructed with a tendon graft using the lengthened flexor digitorum superficialis. The flexor digitorum profundus (FDP) of the ring finger was reconstructed with a tendon graft using the palmaris longus. The FDP of the index and little fingers was reconstructed using the interconnected tendon graft to the ring finger. Postoperatively, active flexion of all fingers and thumb was restored; however, he was unable to grasp thin objects because of the absence of full finger flexion. This is the first case wherein all nine flexor tendons being involved after volar locking plate fixation for a distal radius end fracture. We demonstrated a reconstructive procedure for long-standing multiple flexor tendon rupture after volar locking plate fixation.


Assuntos
Fixação Interna de Fraturas/efeitos adversos , Fraturas do Rádio/cirurgia , Traumatismos dos Tendões/etiologia , Traumatismos dos Tendões/cirurgia , Idoso , Placas Ósseas , Humanos , Masculino , Complicações Pós-Operatórias , Ruptura/etiologia , Ruptura/cirurgia
7.
Int J Sports Med ; 42(8): 682-693, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33784786

RESUMO

Although most studies have introduced risk factors related to anterior cruciate ligament reconstruction failure, studies on combinations of high-risk factors are rare. To provide a systematic review of the risk factors of anterior cruciate ligament reconstruction failure to guide surgeons through the decision-making process, an extensive literature search was performed of the Medline, Embase and Cochrane Library databases. Studies published between January 1, 2009, and September 19, 2019, regarding the existing evidence for risk factors of anterior cruciate ligament reconstruction failure or graft failure were included in this review. Study quality was evaluated with the quality index. Ultimately, 66 articles met our criteria. There were 46 cases classified as technical factors, 21 cases as patient-related risk factors, and 14 cases as status of the knee joint. Quality assessment scores ranged from 14 to 24. This systematic review provides a comprehensive summary of the risk factors for anterior cruciate ligament reconstruction failure, including technical factors, patient-related factors, and the factors associated with the status of the knee joint. Emphasis should be placed on avoiding these high-risk combinations or correcting modifiable risk factors during preoperative planning to reduce the rate of graft rupture and anterior cruciate ligament reconstruction failure.


Assuntos
Reconstrução do Ligamento Cruzado Anterior , Falha de Tratamento , Fatores Etários , Aloenxertos/anatomia & histologia , Reconstrução do Ligamento Cruzado Anterior/métodos , Autoenxertos/anatomia & histologia , Índice de Massa Corporal , Tomada de Decisão Clínica , Humanos , Articulação do Joelho/patologia , Osteotomia/métodos , Complicações Pós-Operatórias/etiologia , Volta ao Esporte , Fatores de Risco , Ruptura/etiologia , Ruptura/prevenção & controle , Tíbia , Lesões do Menisco Tibial/complicações , Suporte de Carga
8.
Surg Radiol Anat ; 43(5): 763-769, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33656594

RESUMO

The flexor pollicis longus (FPL) is located in the anterior compartment of the forearm. It is morphologically variable in both point of origin and insertion. An additional head of the FPL can lead to anterior interosseous syndrome. This report presents a morphological variation of the FPL (additional head in proximal attachment and bifurcated tendinous insertion in distal attachment) and an unrecognized structure that has not so far been described in the literature. This structure originates in six heads (attached to the FPL or interosseous membrane) that merge together, and inserts on to the FPL. All the variations noted have clinical significance, ranging from potential nerve compression to prevention of tendon rupture.


Assuntos
Variação Anatômica , Antebraço/anormalidades , Membrana Interóssea/anormalidades , Músculo Esquelético/anormalidades , Idoso , Feminino , Antebraço/inervação , Humanos , Nervo Mediano/lesões , Síndromes de Compressão Nervosa/etiologia , Ruptura/etiologia , Traumatismos dos Tendões/etiologia
9.
BMJ Case Rep ; 14(2)2021 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-33597165

RESUMO

Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.


Assuntos
COVID-19/prevenção & controle , Pessoal de Saúde/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Ventilação Monopulmonar/normas , Equipamento de Proteção Individual/normas , Acidentes de Trânsito , Adulto , COVID-19/diagnóstico , COVID-19/transmissão , Diafragma/lesões , Diafragma/cirurgia , Humanos , Masculino , Ventilação Monopulmonar/instrumentação , Guias de Prática Clínica como Assunto , Síndrome do Desconforto Respiratório/diagnóstico , Síndrome do Desconforto Respiratório/etiologia , Síndrome do Desconforto Respiratório/terapia , Ruptura/etiologia , Ruptura/terapia
10.
Eur J Med Res ; 26(1): 19, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33557953

RESUMO

BACKGROUND: Diaphragmatic lesions as a result of blunt or penetrating trauma are challenging to detect in the initial trauma setting. This is especially true when diaphragmatic trauma is part of a polytrauma. Complications of undetected diaphragmatic defects with incarcerating bowel are rare, but as in our patient can be serious. CASE PRESENTATION: A 57-year-old female presented to the Emergency Room of our Hospital in a critical condition with 3 days of increasing abdominal pain. The initial clinical examination showed peritonism with tinkling peristaltic bowel sounds of mechanical obstruction. A thoraco-abdominal CT scan demonstrated colon prolapsed through the left diaphragmatic center with a large sero-pneumothorax under tension. As the patient was hemodynamically increasingly unstable with developing septic shock, an emergency laparotomy was performed. After retraction of the left colon, which had herniated through a defect of the tendinous center of the left diaphragm and was perforated due to transmural ischemia, large amounts of feces and gas discharged from the left thorax. A left hemicolectomy resulting in a Hartmann-type procedure was performed. A fully established pleural empyema required meticulous debridement and lavage conducted via the 7-10 cm in diameter phrenic opening followed by a diaphragmatic defect reconstruction. Due to pneumonia and recurring pleural empyema redo-debridement of the left pleural space via thoracotomy were required. The patient was discharged on day 56. A thorough history of possible trauma revealed a bicycle-fall trauma 7 months prior to this hospitalization with a surgically stabilized fracture of the left femur and conservatively treated fractures of ribs 3-9 on the left side. CONCLUSION: This is the first report on a primarily established empyema at the time of first surgical intervention for feco-pneumothorax secondary to delayed diagnosed diaphragmatic rupture following abdomino-thoracic blunt trauma with colic perforation into the pleural space, requiring repetitive surgical debridement in order to control local and systemic sepsis. Thorough investigation should always be undertaken in cases of blunt abdominal and thoracic trauma to exclude diaphragmatic injury in order to avoid post-traumatic complications.


Assuntos
Colo/patologia , Diafragma/lesões , Traumatismo Múltiplo/complicações , Pneumotórax/etiologia , Ciclismo , Colo/cirurgia , Diafragma/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Pneumotórax/cirurgia , Prolapso , Ruptura/etiologia , Ruptura/cirurgia , Traumatismos Torácicos/etiologia
11.
J Med Case Rep ; 15(1): 16, 2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33468218

RESUMO

BACKGROUND: Use of perfluorocarbon liquid (PFCL) has been increasingly growing as an adjuvant in vitreo-retina surgeries. Some commonly encountered complications with its use include subretinal migration, formation of sticky silicone oil or retained PFCL in vitreous cavity and anterior chamber. Scleral rupture during PFCL injection has a rare occurrence. We report an unexpected event of scleral rupture during PFCL injection and discuss the management challenges faced by the surgeon. CASE PRESENTATION: A 66 year indo-aryan male was undergoing pars-plana vitrectomy (PPV) with diagnosis of subtotal rhegmatogenous retinal detachment (RD) with Proliferative Vitreo-retonipathy (PVR)-B. After near total vitrectomy PFCL was being injected and then there was sudden poor visualization of fundus with development of bullous RD and globe hypotony. The surgeon was not able to figure out the cause of hypotony and air was switched on in the infusion cannula. This further complicated the situation resulting in migration of air in the anterior chamber, posterior dislocation of intraocular lens complex, 180° inferior retinal dialysis and ballooning of the conjunctiva which gave a clue of probable scleral rupture. Conjunctival peritomy was performed superiorly and scleral defect was noted. Intraocular tissue incarceration and air leak was visible from the wound. This confirmed scleral rupture during PFCL injection. Repositioning of incarcerated retina was not possible and retinectomy was performed followed by repair of scleral rupture with lots of difficulty in a vitrectomised eye. CONCLUSION: PFCL injection, a crucial step of vitreoretina surgery, should be performed slowly with extreme caution maintaining an optimal intraocular pressure to prevent devastating complications like scleral rupture.


Assuntos
Fluorcarbonetos/administração & dosagem , Complicações Intraoperatórias/etiologia , Injeções Intravítreas/efeitos adversos , Descolamento Retiniano/cirurgia , Ruptura/etiologia , Esclera/lesões , Vitrectomia/métodos , Vitreorretinopatia Proliferativa/cirurgia , Idoso , Traumatismos Oculares/etiologia , Humanos , Masculino , Cirurgia Vitreorretiniana/métodos
12.
Am J Forensic Med Pathol ; 42(1): 67-69, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32649316

RESUMO

ABSTRACT: Isolated right atrial rupture after nonpenetrating blunt chest trauma is rare, and very few cases have been reported in the literature. Isolated right atrial rupture is a diagnostic challenge in these patients, who are mostly victims of motor vehicle collisions. The clinical presentation is heterogeneous and can vary depending on rupture location and size. The anatomical sites mostly involved are the appendage and the free wall followed by the superior and inferior vena cava junctions. The present case study shows a fatal isolated rupture of the right atrial appendage in a victim of a motor vehicle collision. At the emergency room, a computed tomography scan revealed a severe pericardial blood effusion, and pericardiocentesis was promptly performed. Unfortunately, the patient suddenly worsened just before cardiac surgery. Autopsy findings showed a cardiac tamponade due to a linear laceration 1.8 cm in length on the right atrial appendage. No other relevant injuries were observed. A prompt diagnosis of isolated right atrial rupture can be crucial for victims of blunt chest trauma with unexplained hypotension or hemodynamic instability to improve their chances of survival. Medicolegal issues can be raised mainly related to delayed diagnosis. Once a cardiac rupture is suspected, the injury repair is essential to achieve the best outcome.


Assuntos
Acidentes de Trânsito , Apêndice Atrial/lesões , Apêndice Atrial/patologia , Ruptura/patologia , Ferimentos não Penetrantes/complicações , Tamponamento Cardíaco/etiologia , Evolução Fatal , Humanos , Masculino , Derrame Pericárdico/diagnóstico por imagem , Derrame Pericárdico/etiologia , Ruptura/etiologia , Tomografia Computadorizada por Raios X , Adulto Jovem
15.
Ned Tijdschr Geneeskd ; 1642020 11 24.
Artigo em Holandês | MEDLINE | ID: mdl-33332050

RESUMO

A 49-year old male patient presented with a painful swelling of the left thigh after a football trauma. An isolated musculotendinous rectus femoris rupture was diagnosed with ultrasound and MRI. 3 months after surgical repair he was fully recovered in function and strength.


Assuntos
Edema/etiologia , Músculo Quadríceps/lesões , Ruptura/etiologia , Futebol/lesões , Coxa da Perna/lesões , Edema/diagnóstico por imagem , Edema/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Quadríceps/diagnóstico por imagem , Ruptura/diagnóstico por imagem , Ruptura/cirurgia , Coxa da Perna/diagnóstico por imagem , Ultrassonografia
17.
Pan Afr Med J ; 36: 268, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33088397

RESUMO

Bilateral testicular injuries are rare. However, the incidence of these injuries has been increasing in wartime. We describe the case of gunshot wound of the both testicle caused by high velocity bullets. The patient was managed by surgical exploration, debridement and repaired of both testis using tunica vaginalis. During the follow up, the left testis was not viable and there was a need for orchiectomy; in a follow-up of 4 months, ultrasonography showed a viable right testis with minimal atrophic change and the patient reported to have normal erection with borderline hormonal function. We describe this case of bilateral testicular rupture, which was repaired using tunica vaginalis as graft, with attention to the management and outcome of this injury process.


Assuntos
Ruptura/cirurgia , Testículo/cirurgia , Ferimentos por Arma de Fogo/cirurgia , Seguimentos , Humanos , Masculino , Orquiectomia , Ruptura/etiologia , Testículo/diagnóstico por imagem , Testículo/lesões , Ultrassonografia , Ferimentos por Arma de Fogo/diagnóstico por imagem , Adulto Jovem
18.
Clin Sports Med ; 39(4): 877-891, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32892973

RESUMO

Recreational athletes are susceptible to experiencing pain in the Achilles tendon, affecting their ability to complete daily activities. Achilles tendinosis is a degenerative process of the tendon without histologic or clinical signs of intratendinous inflammation, which can be categorized by location into insertional and noninsertional tendinosis. This condition is one that can be treated conservatively with great success or surgically for refractory cases. Currently, there is a lack of consensus regarding the best treatment options. This review aims to explore both conservative and operative treatment options for Achilles tendinopathy and Achilles tendon rupture.


Assuntos
Tendão do Calcâneo/lesões , Traumatismos do Tornozelo/terapia , Traumatismos em Atletas/terapia , Procedimentos Ortopédicos/métodos , Volta ao Esporte , Ruptura/terapia , Tendinopatia/terapia , Tendão do Calcâneo/cirurgia , Traumatismos do Tornozelo/diagnóstico , Traumatismos do Tornozelo/etiologia , Traumatismos do Tornozelo/fisiopatologia , Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/fisiopatologia , Tratamento Conservador/métodos , Humanos , Ruptura/diagnóstico , Ruptura/etiologia , Ruptura/fisiopatologia , Tendinopatia/diagnóstico , Tendinopatia/etiologia , Tendinopatia/fisiopatologia , Resultado do Tratamento
20.
BMJ Case Rep ; 13(9)2020 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-32907864

RESUMO

Traumatic diaphragmatic rupture (TDR) is a rare yet life-threatening occurrence that remains a diagnostic challenge for clinicians. Delayed presentation with associated strangulation of the contents, although uncommon, requires emergent management. A 42-year-old woman presented with constant, severe left-sided shoulder and chest pain, as well as associated upper abdominal pain following a self-contained underwater breathing apparatus (SCUBA) dive. A chest radiograph (CXR) and CT showed a left-sided diaphragmatic hernia containing stomach. She subsequently underwent a laparoscopic repair of the diaphragmatic defect and recovered well postoperatively.


Assuntos
Diafragma/lesões , Mergulho/lesões , Hérnia Diafragmática Traumática/diagnóstico , Ruptura/diagnóstico , Dor Abdominal/etiologia , Dor Abdominal/cirurgia , Adulto , Dor no Peito/etiologia , Dor no Peito/cirurgia , Diafragma/diagnóstico por imagem , Diafragma/cirurgia , Feminino , Hérnia Diafragmática Traumática/etiologia , Herniorrafia/métodos , Humanos , Laparoscopia , Ruptura/etiologia , Ruptura/cirurgia , Tomografia Computadorizada por Raios X
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