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Case Report
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Korean J Med. 2014;87(3):343-346. Published online September 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.87.3.343
- 급성 흉수처럼 보인 횡격막 탈장 1예
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박지선1, 이경희2, 김영삼3, 조재화1, 곽승민1, 류정선1, 남해성1
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1인하대학교 의학전문대학원 내과학교실
2인하대학교 의학전문대학원 영상의학교실
3인하대학교 의학전문대학원 흉부외과학교실
- A Case of Diaphragmatic Hernia Mimicking Acute Pleural Effusion
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Ji Seon Park1, Kyung Hee Lee2, Young Sam Kim3, Jae Hwa Cho1, Seung Min Kwak1, Jeong Seon Ryu1, Hae Seong Nam1
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1Departments of Internal Medicine, Inha University School of Medicine, Incheon, Korea
2Departments of Radiology, Inha University School of Medicine, Incheon, Korea
3Departments of Thoracic Surgery, Inha University School of Medicine, Incheon, Korea
- Corresponding author: Jae Hwa Cho ,Tel: +82-32-890-3490, Fax: +82-32-882-6578, Email: Jaehwa.cho@inha.ac.kr
- Received: October 17, 2013; Revised: December 27, 2013 Accepted: March 21, 2014.
- 횡격막 탈장은 복강 내 장기가 횡격막 결손을 통해서 흉강내로 이동하는 것으로 선척적인 횡격막 발달 이상 혹은 외상, 수술, 감염 등 후천적 원인에 의하여 발생한다. 소아에서는 급성 호흡기 증상을 유발하지만 성인에서는 위-역류 증상, 구토, 복부 불편감, 가슴통증, 숨찬 증상 등 만성적이고 다양한 증상으로 나타날 수 있다. 저자들은 가슴 통증을 호소하여 내원한 성인에서 단순 흉부 X-선 촬영상 흉막액과 유사하게 보였으나 흉부 CT 촬영을 통하여 횡격막 결손 및 그물막 탈장을 진단하고 수술적 치료까지 시행한 1예를 경험하여 보고하였다.
߽ɾ :횡격막 탈장; 흉막액; 가슴통증; 전산화 단층촬영
- Abstract
- Diaphragmatic hernia may be either congenital or acquired. Acquired cases may be secondary to trauma, infection, pregnancy, or surgery. In adults, diaphragmatic hernia causes chronic and variable symptoms such as abdominal discomfort, dyspepsia, and chronic dyspnea; in infants, however, it frequently causes acute respiratory failure. We report herein a case of diaphragmatic hernia in an adult patient who presented with left chest pain. Left pleural effusion was revealed on a plain chest radiograph. Computed tomography confirmed the presence of a diaphragmatic defect and a shift of the omentum to the thoracic cavity. The patient underwent omental resection and primary repair of the diaphragmatic muscle defect via exploratory thoracotomy.
Keywords :Diaphragmatic hernia, Pleural effusion, Chest pain, Computed tomography
