Author/Editor		Hermann, Dejan; Srpčič, Matevž; Bitenc, Marko
Title		Subakutna manifestacija spontanega pretrganja trebušne prepone: predstavitev primera
Translated title		Subacute presentation of spontaneous diaphragmal rupture: case report
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 74, št. 7-8
Publication year		2005
Volume		str. 439-41
Language		slo
Abstract		Background. Diaphragmatic injuries are relatively rare and present with non specific symptoms and signs. Late discoveries are almost a rule in all but the most evident cases. Many patients are observed or even treated for suspected other conditions, most often musculosceletal disorders. Patients and methods. We report a case of a 14-year-old boy who presented with left lumbar pain and developed peritonitis six days after strenuous training. A chest X-ray revealed abdominal viscera in the left hemithorax. A large posterolateral rupture of the left diaphragm was found at laparotomy together with herniation of the stomach, spleen and colon. The stomach was perforated and partialy necrotic. After partial gastrectomy, repositioning and diaphragmal repair the patient recovered well. Conclusions. If pain in toracoabdominal region is a predominant sign after trauma or endogenous strain, one should consider the posibility of ruptured diaphragm and make a chest X-ray. Operation of diaphragmal hernia is necessary and garanties good results when treated on time.
Summary		Izhodišča. Spontana pretrganja trebušne prepone so redek pojav, ki se kaže z nespecifičnimi znaki in simptomi. Pozna odkritja so skoraj pravilo, bolniki pa so pred tem najpogosteje zdravljeni zaradi suma na mišično-skeletno poškodbo. Bolniki in metode. Predstavljamo primer 14-letnega dečka, ki ga je po napornem treniranju trebušnih mišic pričelo boleti ledveno levo, nato pa je po šestih dneh razvil znake peritonitisa. Rentgenogram prsnih organov je pokazal trebušne organe v levi strani prsnega koša. Pri laparotomiji je bila odkrita velika posterolateralna raztrganina trebušne prepone in skozi njo herniacija želodca, vranice in debelega črevesa. Želodec je bil perforiran in delno nekrotičen. Pri bolniku smo delno resecirali želodec, reponirali herniirane trebušne organe in prešli prepono. Po posegu je bolnik dobro okreval. Zaključki. Po poškodbi ali po izrazitem naporu, po katerem se pojavijo bolečine v torakoabdominalnem področju, je potrebno pomisliti na možnost pretrganja trebušne prepone in se zgodaj odločiti za rtg slikanje prsnega koša. Operacija po pojavu herniacije je nujna in zagotavlja dobre rezultate.
Descriptors		DIAPHRAGM RUPTURE, SPONTANEOUS EXERTION HERNIA, DIAPHRAGMATIC, TRAUMATIC PERITONITIS CHILD