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Ann Thorac Surg 1984;38:526-528
© 1984 The Society of Thoracic Surgeons

Articles

Triple Diaphragmatic Rupture with Disruption of the Pericardium: Pericardial Reconstruction by Lyophilized Dura Allograft

Freya Jüttner, M.D.1, Hans Pinter, M.D., Dieter Kampler, M.D., Karlheinz Tscheliessnigg, M.D., Gerhard Friehs, M.D.

Department of Thoracic and Hyperbaric Surgery, University Clinic for Surgery, Graz, Austria

Accepted for publication February 3, 1984.

1 Address reprint requests to Dr. Jüttner, Thoracic Surgery, A-8036 LKH, Graz, Austria.

A patient is described with the unusual findings of intrapericardial diaphragmatic rupture combined with total disruption of the pericardium and partial abruption of the diaphragm from its costal origin. Through a third traumatic diaphragmal leak, the small intestine had prolapsed intercostally without contact to the pleural space. Surgical repair was done by direct diaphragmatic suturing and lyophilized dura allograft reconstruction of the left pericardial circumference. Postoperatively, atrioventricular block secondary to myocardial contusion necessitated pacemaker implantation. The patient left the hospital five weeks after the injury.






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