Varón de 29 años que sufre traumatismo dorsolumbar cerrado de alta energía por desprendimiento de una roca. Ante la estabilidad hemodinámica, se realiza TC urgente que no aprecia lesión diafragmática (fig. 1). Se coloca tubo de tórax y fijación pélvica. Al tercer día aparece velamiento del hemitórax derecho en la radiografía de control y se realiza nueva TC que objetiva rotura diafragmática derecha (fig. 2). Se realiza laparotomía subcostal derecha (fig. 3), reducción del contenido y cierre primario del desgarro mediante sutura continua de PDS loop® reforzada posteriormente mediante prótesis Proceed® fijada con sutura de polipropileno y adhesivo de fibrina.
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Ante la estabilidad hemodinámica, se realiza TC urgente que no aprecia lesión diafragmática (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>). Se coloca tubo de tórax y fijación pélvica. Al tercer día aparece velamiento del hemitórax derecho en la radiografía de control y se realiza nueva TC que objetiva rotura diafragmática derecha (<a class="elsevierStyleCrossRef" href="#fig0010">fig. 2</a>). Se realiza laparotomía subcostal derecha (<a class="elsevierStyleCrossRef" href="#fig0015">fig. 3</a>), reducción del contenido y cierre primario del desgarro mediante sutura continua de PDS loop<span class="elsevierStyleSup">®</span> reforzada posteriormente mediante prótesis Proceed<span class="elsevierStyleSup">®</span> fijada con sutura de polipropileno y adhesivo de fibrina.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:3 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 450 "Ancho" => 550 "Tamanyo" => 86384 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 450 "Ancho" => 537 "Tamanyo" => 93739 ] ] ] 2 => array:6 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 450 "Ancho" => 446 "Tamanyo" => 63938 ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/0009739X/0000009300000009/v1_201511060112/S0009739X15001657/v1_201511060112/es/main.assets" "Apartado" => array:4 [ "identificador" => "15025" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "La imagen del mes" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/0009739X/0000009300000009/v1_201511060112/S0009739X15001657/v1_201511060112/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X15001657?idApp=UINPBA00004N" ]