A Case of Traumatic Left Hemi–diaphragmatic Injury Caused by a Seat Belt

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  • シートベルトによる外傷性左横隔膜単独損傷の1例
  • シートベルト ニ ヨル ガイショウセイ サ オウカクマク タンドク ソンショウ ノ 1レイ

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Abstract

<p>The patient was a 71–year–old man who sustained injuries in a traffic accident in which the vehicle he was riding in collided with an oncoming car while turning right, and presented with a decrease in peripheral arterial oxygen saturation. He was brought to our hospital by ambulance approximately 1 hour after he sustained the injury. At arrival, the patient’s SpO2 was 97％ (oxygen 10 L), but the patient was conscious and there were no other remarkable hemodynamic findings. Blood tests revealed an elevated white blood cell count (13,600/μL) and mild anemia (Hb 11.8 g/dL). Contrast–enhanced abdominal computed tomography revealed a left diaphragmatic perforation, prolapse of the stomach and descending colon into the thoracic cavity, and left lung exclusion, but no other apparent fractures or organ damage. Based on the above findings, the patient was diagnosed as having left traumatic diaphragmatic injury and underwent emergency surgery on the same day. A laceration, measuring approximately 10 cm, was found in the left diaphragm, and the stomach and descending colon had prolapsed into the thoracic cavity from the same site. There was no apparent organ damage, and the organs were manually repositioned into the abdominal cavity. The diaphragm was sutured with 2–0 Prolene, and a left chest drain was put in place. The patient’s postoperative course was good, and the drain was removed on day 4; the patient was discharged on day 15. Lone traumatic diaphragmatic injury is rare, therefore, we report this case with a review of the relevant literature.</p>

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