A CASE OF TRAUMATIC DIAPHRAGMATIC HERNIA INDUCED BY CARDIOPULMONARY RESUSCITATION

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A 34-year-old man had had an episode of steering-trauma in a traffic accident when he was 25 years old. He visited a hospital with chief complaints of sudden chest pain and cold sweating. A chest x-ray revealed a slight elevation and an indistinct line in the right diaphragm. Just at that time, cardiac arrest caused by myocardial infarction occurred and cardiopulmonary resuscitation was performed. The patient was transferred to our hospital and his life was saved. A chest x-ray revealed the collapse of the right lung and intestinal gas shadow occupying the whole right pulmonary field. We speculated that this diaphragmatic hernia induced by cardiopulmonary resuscitation originating from an old diaphragmatic rupture. Findings of the emergency operation under thoracolaparotomy showed that the diaphragm was almost defective and the stomach, greater omentum and small and large intestines were translocated to the pleural cavity. An operation was performed in which the peritoneal organs were replaced and the right diaphragm was reconstructed. Surgery is indicated for this condition immediately upon diagnosis. We need to bear this conditionin mind when listening to details past history, as one of several traumas and diseases with long latentperiods.
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