<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1028-4818</journal-id>
<journal-title><![CDATA[Multimed]]></journal-title>
<abbrev-journal-title><![CDATA[Multimed]]></abbrev-journal-title>
<issn>1028-4818</issn>
<publisher>
<publisher-name><![CDATA[Centro Provincial de Información de Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1028-48182021000300014</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Ruptura diafragmática traumática: presentación de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Traumatic diaphragmatic rupture: presentation of a case]]></article-title>
<article-title xml:lang="pt"><![CDATA[Ruptura diafragmática traumática: apresentação de um caso]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acosta Guerrero]]></surname>
<given-names><![CDATA[Gleidys]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Delgado Llorca]]></surname>
<given-names><![CDATA[Fred]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guerra Corría]]></surname>
<given-names><![CDATA[Yamila]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Ciencias Médicas de Granma Hospital General Docente Universitario Carlos Manuel de Céspedes ]]></institution>
<addr-line><![CDATA[Bayamo Granma]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>25</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1028-48182021000300014&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1028-48182021000300014&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1028-48182021000300014&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción: el diafragma es un tabique que separa el tórax del abdomen y su función fisiológica es ayudar a la mecánica de la ventilación. La ruptura diafragmática traumática es una entidad de difícil diagnóstico inicial, por la baja sospecha clínica, lo que lleva a complicaciones como la estrangulación, que tiene una elevada morbimortalidad. Las lesiones traumáticas del diafragma son poco frecuentes, la incidencia global por mecanismo penetrante y cerrado es del 1 % al 6 %.  Presentación de caso: paciente masculino de 20 años de edad con antecedentes de salud aparente, acude al servicio de urgencia a las 2 horas luego de haber sufrido accidente laboral al desprenderse un banco de arena sobre él, refiriendo dificultad para respirar y dolor torácico en hemitorax izquierdo, los estudios de imágenes practicados mostraron presencia de cámara gástrica y colon en hemitorax izquierdo, es intervenido quirúrgicamente con impresión diagnostica de ruptura diafragmática secundaria a traumatismo cerrado de abdomen. Durante el transoperatorio se comprobó la misma (laceración lineal que involucra todo hemidiafragma izquierdo) con herniación del estómago, bazo, colon transverso y parte de intestino delgado en cavidad torácica. Se realizó frenorrafia y pleurostomia baja izquierda. No otras alteraciones intraabdominales.  Discusión:  la rotura traumática del diafragma es una lesión infrecuente que ocurre como consecuencia de traumatismos cerrados y penetrantes del abdomen o del tórax. Su diagnóstico precoz continúa siendo un desafío y se asocia con una elevada morbimortalidad. El diagnóstico preoperatorio es difícil y sólo un alto nivel de sospecha, un examen minucioso de las técnicas de imagen y la intervención quirúrgica inmediata, son determinantes para el éxito en el tratamiento de estos pacientes.  Conclusiones: nuestro paciente no presentó complicaciones mayores en el perioperatorio, a las 24 horas estaba con dieta y deambulando se retiró la sonda pleural a las 72 horas y ha tenido una evolución favorable libre de síntomas, siendo dado de alta a los 10 días.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  the diaphragm is a septum that separates the thorax from the abdomen and its physiological function is to help the mechanics of ventilation. Traumatic diaphragmatic rupture is an entity of difficult initial diagnosis, due to low clinical suspicion, which leads to complications such as strangulation, which has high morbidity and mortality. Traumatic injuries to the diaphragm are rare, the overall incidence due to penetrating and closed mechanism is 1% to 6%.  Case presentation:  20-year-old male patient with apparent health history, attended the emergency service 2 hours after having suffered an occupational accident when a sandbar fell off him, reporting difficulty breathing and chest pain in hemithorax On the left, the imaging studies performed showed the presence of a gastric chamber and colon in the left hemithorax, he was operated on with a diagnostic impression of a diaphragmatic rupture secondary to blunt abdominal trauma. During the intraoperative it was verified (linear laceration involving the entire left hemidiaphragm) with herniation of the stomach, spleen, transverse colon and part of the small intestine in the thoracic cavity. Left low pleurostomy and frenorrhaphy were performed. No other intra-abdominal alterations.  Discussion:  traumatic diaphragm rupture is an infrequent injury that occurs as a consequence of blunt and penetrating trauma to the abdomen or chest. Early diagnosis of it continues to be a challenge and is associated with high morbidity and mortality. Preoperative diagnosis is difficult and only a high level of suspicion, a thorough examination of imaging techniques, and immediate surgical intervention are decisive for the success of treating these patients.  Conclusions:  our patient did not present major complications in the perioperative period, at 24 hours he was on a diet and wandering, the pleural tube was removed at 72 hours and has had a favorable symptom-free evolution, being discharged at 10 days.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Introdução: o diafragma é um septo que separa o tórax do abdome e sua função fisiológica é auxiliar na mecânica da ventilação. A ruptura diafragmática traumática é uma entidade de difícil diagnóstico inicial, devido à baixa suspeita clínica, o que leva a complicações como o estrangulamento, que apresenta elevada morbimortalidade. Lesões traumáticas do diafragma são raras, a incidência geral devido ao mecanismo penetrante e fechado é de 1% a 6%.  Apresentação do caso:  Paciente do sexo masculino, 20 anos, com história aparente de saúde, compareceu ao pronto-socorro 2 horas após ter sofrido acidente de trabalho com queda de banco de areia, relatando dificuldade respiratória e dor torácica em hemitórax À esquerda, exames de imagem realizados mostrou a presença de câmara gástrica e cólon em hemitórax esquerdo, foi operado com impressão diagnóstica de ruptura diafragmática secundária a trauma abdominal fechado. No intraoperatório, constatou-se (laceração linear envolvendo todo o hemidiafragma esquerdo) com herniação do estômago, baço, cólon transverso e parte do intestino delgado na cavidade torácica. Realizada pleurostomia baixa esquerda e frenorrafia. Sem outras alterações intra-abdominais.  Discussão:  a ruptura traumática do diafragma é uma lesão infrequente que ocorre como consequência de trauma contuso e penetrante no abdome ou no tórax. Seu diagnóstico precoce continua sendo um desafio e está associado a elevada morbimortalidade. O diagnóstico pré-operatório é difícil e apenas um alto nível de suspeita, um exame cuidadoso das técnicas de imagem e a intervenção cirúrgica imediata são decisivos para o sucesso do tratamento desses pacientes.  Conclusões:  nosso paciente não apresentou complicações maiores no período perioperatório, às 24 horas fazia dieta e vagueava, a tuba pleural foi retirada às 72 horas e teve evolução favorável sem sintomas, tendo alta hospitalar aos 10 dias.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Ruptura del diafragma]]></kwd>
<kwd lng="es"><![CDATA[Trauma abdominal, Trauma torácico]]></kwd>
<kwd lng="en"><![CDATA[Diaphragm rupture]]></kwd>
<kwd lng="en"><![CDATA[Abdominal trauma, Thoracic trauma]]></kwd>
<kwd lng="pt"><![CDATA[Ruptura do diafragma]]></kwd>
<kwd lng="pt"><![CDATA[Trauma abdominal, Trauma toracico]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Páez Ruiz]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz Ramírez]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Álvarez Padilla]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Manejo del tórax inestable (volet costal)]]></article-title>
<source><![CDATA[Rev. Electrónica de Portales Medicos.com]]></source>
<year>2018</year>
<volume>13</volume>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yépez Yerovi]]></surname>
<given-names><![CDATA[FE]]></given-names>
</name>
<name>
<surname><![CDATA[García Orozco]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Loaiza Merino]]></surname>
<given-names><![CDATA[IP]]></given-names>
</name>
<name>
<surname><![CDATA[Escalona Rabasa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Santillán Pilca]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[García Boyx]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Caso clínico de trauma severo en región toracoabdominal izquierda con afectación de ambas cavidades]]></article-title>
<source><![CDATA[Enfermería Investiga]]></source>
<year>2020</year>
<volume>5</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[León Heredia]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández Dinza]]></surname>
<given-names><![CDATA[PA]]></given-names>
</name>
<name>
<surname><![CDATA[López Rivera]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Alexander Pérez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ruptura diafragmática y esplénica de origen traumático en un adolescente]]></article-title>
<source><![CDATA[Rev Cubana Pediatr]]></source>
<year>2020</year>
<volume>92</volume>
<numero>1</numero>
<issue>1</issue>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lerendegui]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Gauto]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Esnaola]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Udaquiola]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Vagni]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Lobos]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ruptura diafragmática postraumática en pediatría. A propósito de un caso]]></article-title>
<source><![CDATA[Arch Argent Pediatr]]></source>
<year>2018</year>
<volume>116</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>e292-5</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Berríos Bárcena]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hinojosa Velazco]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Flores Revilla]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Mamani Chirinos]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ruptura diafragmática traumática: Presentación de un caso.]]></article-title>
<source><![CDATA[Rev. Colomb. Radiol.]]></source>
<year>2015</year>
<volume>26</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>4283-8</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Domínguez González]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Diéguez Campa]]></surname>
<given-names><![CDATA[CE]]></given-names>
</name>
<name>
<surname><![CDATA[Alfaro Ávila]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Protrusión de órganos abdominales en ruptura diafragmática traumática]]></article-title>
<source><![CDATA[Acta Médica Grupo Ángeles]]></source>
<year>2019</year>
<volume>17</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>141-4</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Charco Roca]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Simón Polo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluación ecográfica de la función diafragmática en el paciente crítico]]></article-title>
<source><![CDATA[Revista Electrónica Anestesia]]></source>
<year>2019</year>
<volume>11</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vázquez Minero]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Portillo Téllez]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez Vázquez]]></surname>
<given-names><![CDATA[JV]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lesión diafragmática por trauma penetrante y manifestación tardía con oclusión intestinal]]></article-title>
<source><![CDATA[Neumol Cir Tórax]]></source>
<year>2020</year>
<volume>79</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>50-2</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morán Marsili]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Buitrago Weilland]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Diez Tascón]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Simón Merlo]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Martí de Gracia]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rotura traumática de hemidiafragma izquierdo]]></article-title>
<source><![CDATA[Sociedad Española de Radiología de Urgencias]]></source>
<year>2017</year>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Esquenazi]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Restegui]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Trauma de Tórax]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[De Gracia]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Reilly]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<source><![CDATA[Manual de Cirugía]]></source>
<year>2019</year>
<publisher-loc><![CDATA[Argentina ]]></publisher-loc>
<publisher-name><![CDATA[Asociación Argentina de Cirugía]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vázquez Minero]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Arriola Nava]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Quiroga Arias]]></surname>
<given-names><![CDATA[VE]]></given-names>
</name>
<name>
<surname><![CDATA[Cervantes Silva]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ruptura diafragmática postraumática de presentación tardía. A propósito de dos casos]]></article-title>
<source><![CDATA[Neumol Cir Tórax]]></source>
<year>2018</year>
<volume>77</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>151-6</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Araujo Cuauro]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hernia diafragmática traumática crónica en fase catastrófica u obstructiva. Revisión de la literatura a propósito de un caso]]></article-title>
<source><![CDATA[VITAE Academia Biomédica de Salud]]></source>
<year>2018</year>
<numero>75</numero>
<issue>75</issue>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
