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1 病例介绍 例1,女,9个月。反复呕吐、发热、伴肛门停止排气排便4天。查体:营养发育良好,无青紫,左胸略饱满,叩诊呈鼓音,左肺呼吸音减低,可闻及肠鸣音,腹部触之有空虚感。胸片示:纵隔右移,左胸腔内可见不规则充气肠袢影。胃肠造影示:左胸腔有含钡剂肠管影。在静脉复合麻醉下剖胸手术。术中见:疝入胸腔主要为小肠,部分结肠,肠段无坏死,给回纳腹腔,修补膈肌。痊愈出院。 例2,男,12岁。主诉无不适。查体:胸廓对称,稍呈鸡胸。左下肺呼吸音消失,未闻及明显肠鸣音,右肺呼吸音清晰,心音不清,左上腹部有一手术疤痕长约15cm,系出生2月时,曾在外院拟诊左先天性膈疝经腹施行手术。
A case introduction example 1, female, 9 months. Repeated vomiting, fever, with anus to stop the exhaust defecation 4 days. Physical examination: well-developed nutrition, no bruising, left chest slightly full, percussion was Drum sound, reduced left lung breath sounds, can be heard and bowel sounds, the abdomen touch emptiness. Chest X-ray showed: mediastinal right shift, visible irregular pleura in the left chest shadow. Gastrointestinal angiography showed: the left chest with barium enema shadow. Thoracotomy under intravenous anesthesia. See intraoperative: hernia into the chest is mainly the small intestine, part of the colon, bowel necrosis, back to the satisfied abdominal cavity to repair the diaphragm. Healed and discharged. Example 2, male, 12 years old. No complaint of complaints. Examination: chest symmetry, slightly chicken breast. The left lower lung breath sounds disappear, unobstructed and obvious bowel sounds, right lung breath sounds clear, heart sounds unclear, left upper abdomen has a surgical scar about 15cm, was born in February, had been diagnosed in the outer hospital left congenital diaphragmatic hernia Performing surgery.