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Acta Médica Costarricense

versão On-line ISSN 0001-6002versão impressa ISSN 0001-6012


OSPINO- SAUMETT, Giovanni; MARTINEZ- BARBOSA, Patricia  e  VALVERDE- ROBERT, Raúl. Vólvulo gástrico intratorácico secundario a hernia diafragmática izquierda crónica postraumática. Acta méd. costarric [online]. 2005, vol.47, n.2, pp.94-96. ISSN 0001-6002.

Diaphragmatic rupture occurs in 5% of severe thoracoabdominal trauma and the herniation of abdominal visceral to the thorax happens in 45 to 60% of the cases. The stomach is the organ more frequently herniated2. Complete intrathoracic gastric volvulus is uncommon in traumatic diaphragmatic hernia, in which the stomach undergoes organoaxial torsion predisposing to strangulation and necrosis. It may appear as a surgical emergency, though chronic patients with non specifics symptoms can be treated electively5. Traumatic diaphragmatic herniae are a diagnostic challenge to the surgeon. They are usually caused by blunt abdominal trauma, and less often by blunt thoracic trauma. They are located on the left side in 90% of all cases, probably secondary to the "buffer" effect of the liver on the right side. A rupture of the diaphragm is not diagnosed during the acute posttraumatic period in up to 40% of the cases, because it can remain asymptomatic or it may give nonspecific symptoms, that can appear hours or days after trauma. If the rupture stays unrecognized, a latency period ranging from hours to many years occurs until a significant thoracic prolapse of abdominal organs develops, causing a variety of symptoms. Once diagnosed a traumatic diaphragmatic hernia is an absolute and urgent indications for surgical therapy1,6. We present the case of a 24 year old male with the history of toracoabdominal trauma, who had an intrathoracic gastric volvulus. He was handle surgically and did fine

Palavras-chave : hernia diafragmática crónica traumática; vólvulo gástrico; diagnóstico; tratamiento quirúrgico.

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